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This study presents the synthesis and characterization of nanocomposites based on polymer colloids (PC) and MXenes for applications in EMI shielding. The PCs were synthesized in the presence of MXenes by soap-free emulsion polymerization. The presence of the MXenes during the polymerization process induces changes in the nucleation process, which also occurs between the MXenes layers, leading to intercalated and finally fully exfoliated structures arising from the polymerization progress. Two co-monomer systems were synthesized in the presence of MXenes, both based on styrene (ST) and a second monomer, with different hydrophilic characteristics acrylic acid (AA) and hydroxypropyl methacrylate (HPMA), respectively. The nanocomposites were characterized by SEM, DLS, XRD, TGA, and EMI shielding capacity analyses. The analyses confirmed better compatibility between HPMA and the MXenes, which facilitated the formation of an exfoliated structure. The polymer colloids were incorporated into an epoxy resin to evaluate their EMI shielding abilities. The EMI tests showed that the electromagnetic properties of the epoxy film varied depending on the concentration of ST-HPMA-MXenes, resulting in increased electromagnetic transparency or absorption capacity. [ABSTRACT FROM AUTHOR]

Shear thickening fluids (STFs) have garnered attention as potential enhancers of protective capabilities and for the optimization of Kevlar® armor design. To assess the possible shear thickening properties and potential application in ballistic protection, ten formulations were developed by employing polyethylene glycol (PEG) or polypropylene glycol (PPG), along with fumed silica or Aerosil HDK®. Rheological characterization facilitated the identification of formulations displaying shear thickening behavior. The potential integration of the selected shear thickening fluids (STFs) into Kevlar®-based composites was investigated by studying the impact resistance of Kevlar® soft armor structures. Also, high-velocity impact testing revealed that the distance between aramid layers plays a crucial role in the impact resistance effectiveness of Kevlar®–STF composite structures and that there is a very narrow domain between optimal and undesired scenarios in which STF could facilitate the penetration of Kevlar. The introduction of STF between the Kevlar sheets disrupted this packing and the energy absorption capacity of the material was not improved. Only one formulation (PEG400, Aerosil 27 wt.%) led to a less profound traumatic imprint and stopped the bullet when it was placed between layers no.1 and no.2 from a total of 11 layers of Kevlar XP. These experimental findings align with the modeling and simulation of Kevlar®–STF composites using Ansys simulation software (Ansys® AutoDyn 2022 R2). [ABSTRACT FROM AUTHOR]

Rationale: Observational studies suggest that high-dose isoniazid may be efficacious in treating multidrug-resistant tuberculosis. However, its activity against Mycobacterium tuberculosis (M.tb) with katG mutations (which typically confer high-level resistance) is not established. Objectives: To characterize the early bactericidal activity (EBA) of high-dose isoniazid in patients with tuberculosis caused by katG-mutated M.tb. Methods: A5312 was a phase IIA randomized, open-label trial. Participants with tuberculosis caused by katG-mutated M.tb were randomized to receive 15 or 20 mg/kg isoniazid daily for 7 days. Daily sputum samples were collected for quantitative culture. Intensive pharmacokinetic sampling was performed on Day 6. Data were pooled across all A5312 participants for analysis (drug-sensitive, inhA-mutated, and katG-mutated M.tb). EBA was determined using nonlinear mixed-effects modeling. Measurements and Main Results: Of 80 treated participants, 21 had katG-mutated M.tb. Isoniazid pharmacokinetics were best described by a two-compartment model with an effect of NAT2 acetylator phenotype on clearance. Model-derived maximum concentration and area under the concentration–time curve in the 15 and 20 mg/kg groups were 15.0 and 22.1 mg/L and 57.6 and 76.8 mg ⋅ h/L, respectively. Isoniazid bacterial kill was described using an effect compartment and a sigmoidal maximum efficacy relationship. Isoniazid potency against katG-mutated M.tb was approximately 10-fold lower than in inhA-mutated M.tb. The highest dose of 20 mg/kg did not demonstrate measurable EBA, except against a subset of slow NAT2 acetylators (who experienced the highest concentrations). There were no grade 3 or higher drug-related adverse events. Conclusions: This study found negligible bactericidal activity of high-dose isoniazid (15–20 mg/kg) in the majority of participants with tuberculosis caused by katG-mutated M.tb. Clinical trial registered with (NCT01936831). [ABSTRACT FROM AUTHOR]

This study describes the development of hydrogel formulations with ionic crosslinking capacity and photocatalytic characteristics. The objective of this research is to provide an effective, accessible, "green", and facile route for the decontamination of chemical warfare agents (CWAs, namely the blistering agent—mustard gas/sulfur mustard (HD)) from contaminated surfaces, by decomposition and entrapment of CWAs and their degradation products inside the hydrogel films generated "on-site". The decontamination of the notorious warfare agent HD was successfully achieved through a dual hydrolytic–photocatalytic degradation process. Subsequently, the post-decontamination residues were encapsulated within a hydrogel membrane film produced via an ionic crosslinking mechanism. Polyvinyl alcohol (PVA) and sodium alginate (ALG) are the primary constituents of the decontaminating formulations. These polymeric components were chosen for this application due to their cost-effectiveness, versatility, and their ability to form hydrogen bonds, facilitating hydrogel formation. In the presence of divalent metallic ions, ALG undergoes ionic crosslinking, resulting in rapid gelation. This facilitated prompt PVA-ALG film curing and allowed for immediate decontamination of targeted surfaces. Additionally, bentonite nanoclay, titanium nanoparticles, and a tetrasulfonated nickel phthalocyanine (NiPc) derivative were incorporated into the formulations to enhance absorption capacity, improve mechanical properties, and confer photocatalytic activity to the hydrogels obtained via Zn2+—mediated ionic crosslinking. The resulting hydrogels underwent characterization using a variety of analytical techniques, including scanning electron microscopy (SEM), Fourier transform infrared spectroscopy (FTIR), viscometry, and mechanical analysis (shear, tensile, and compression tests), as well as swelling investigations, to establish the optimal formulations for CWA decontamination applications. The introduction of the fillers led to an increase in the maximum strain up to 0.14 MPa (maximum tensile resistance) and 0.39 MPa (maximum compressive stress). The UV-Vis characterization of the hydrogels allowed the determination of the band-gap value and absorption domain. A gas chromatography–mass spectrometry assay was employed to evaluate the decontamination efficacy for a chemical warfare agent (sulfur mustard—HD) and confirmed that the ionic crosslinked hydrogel films achieved decontamination efficiencies of up to 92.3%. Furthermore, the presence of the photocatalytic species can facilitate the degradation of up to 90% of the HD removed from the surface and entrapped inside the hydrogel matrix, which renders the post-decontamination residue significantly less dangerous. [ABSTRACT FROM AUTHOR]

(1) Background: Some individuals are more susceptible to developing respiratory tract infections (RTIs) or coronavirus disease (COVID-19) than others. The aim of this work was to identify risk factors for symptomatic RTIs including COVID-19 and symptomatic COVID-19 during the coronavirus pandemic by using infection incidence, participant baseline, and regional COVID-19 burden data. (2) Methods: Data from a prospective study of 1000 frontline healthcare workers randomized to Bacillus Calmette–Guérin vaccination or placebo, and followed for one year, was analyzed. Parametric time-to-event analysis was performed to identify the risk factors associated with (a) non-specific symptomatic respiratory tract infections including COVID-19 (RTIs+COVID-19) and (b) symptomatic RTIs confirmed as COVID-19 using a polymerase chain reaction or antigen test (COVID-19). (3) Results: Job description of doctor or nurse (median hazard ratio [HR] 1.541 and 95% confidence interval [CI] 1.299–1.822), the reported COVID-19 burden (median HR 1.361 and 95% CI 1.260–1.469 for 1.4 COVID-19 cases per 10,000 capita), or a BMI > 30 kg/m2 (median HR 1.238 and 95% CI 1.132–1.336 for BMI of 35.4 kg/m2) increased the probability of RTIs+COVID-19, while positive SARS-CoV-2 serology at enrollment (median HR 0.583 and 95% CI 0.449–0.764) had the opposite effect. The reported COVID-19 burden (median HR 2.372 and 95% CI 2.116–2.662 for 1.4 COVID-19 cases per 10,000 capita) and a job description of doctor or nurse (median HR 1.679 and 95% CI 1.253–2.256) increased the probability of developing COVID-19, while smoking (median HR 0.428 and 95% CI 0.284–0.648) and positive SARS-CoV-2 serology at enrollment (median HR 0.076 and 95% CI 0.026–0.212) decreased it. (4) Conclusions: Nurses and doctors with obesity had the highest probability of developing RTIs including COVID-19. Non-smoking nurses and doctors had the highest probability of developing COVID-19 specifically. The reported COVID-19 burden increased the event probability, while positive SARS-CoV-2 IgG serology at enrollment decreased the probability of RTIs including COVID-19, and COVID-19 specifically. [ABSTRACT FROM AUTHOR]

This review presents polyurea (PU) synthesis, the structure–properties relationship, and characterization aspects for ballistic protection applications. The synthesis of polyurea entails step-growth polymerization through the reaction of an isocyanate monomer/prepolymer and a polyamine, each component possessing a functionality of at least two. A wide range of excellent properties such as durability and high resistance against atmospheric, chemical, and biological factors has made this polymer an outstanding option for ballistic applications. Polyureas are an extraordinary case because they contain both rigid segments, which are due to the diisocyanates used and the hydrogen points formed, and a flexible zone, which is due to the chemical structure of the polyamines. These characteristics motivate their application in ballistic protection systems. Polyurea-based coatings have also demonstrated their abilities as candidates for impulsive loading applications, affording a better response of the nanocomposite-coated metal sheet at the action of a shock wave or at the impact of a projectile, by suffering lower deformations than neat metallic plates. [ABSTRACT FROM AUTHOR]

The first aim of this study is to develop a photo‐ATRP process using methyl methacrylate (MMA) by employing a novel perylenediimide derivative (PDI) as photoinitiator. The analysis of the MMA photopolymerization process kinetics is performed in solution and in bulk, demonstrating control over the reaction progress even if the polymerizations display a slow initiation step. The photo‐ATRP process for MMA in suspension is also developed and the obtained PMMA particles are further used to reinitiate the ATRP polymerization of thermoresponsive polymers (different molecular weights poly(ethylene glycol) methyl ether methacrylate and poly(N‐isopropylacrylamide)) (PNIPAM) in solution and surface‐initiated processes. The synthesized polymers by surface‐initiated process display a bimodal molecular weight distribution with a clear modification of the signal areas ratio depending on the grafted monomer and on the reaction conditions. The grafting process can take place on the surface of the polymer particles (Mn2), or it can also involve polymer chains located further at the interior of the polymer particles (Mn1). The lower critical solution temperature (LCST) transition is demonstrated for the PNIPAM functionalized polymer particles. [ABSTRACT FROM AUTHOR]

This study describes the development of a fast and cost-effective method for the detection and removal of Hg2+ ions from aqueous media, consisting of hydrogels incorporating chelating agents and a rhodamine derivative (to afford a qualitative evaluation of the heavy metal entrapment inside the 3D polymeric matrix). These hydrogels, designed for the simultaneous detection and entrapment of mercury, were obtained through the photopolymerization of 2-acrylamido-2-methyl-1-propanesulfonic acid (AMPSA) and N-vinyl-2-pyrrolidone (NVP), utilizing N,N′-methylenebisacrylamide (MBA) as crosslinker, in the presence of polyvinyl alcohol (PVA), a rhodamine B derivative, and one of the following chelating agents: phytic acid, 1,3-diamino-2-hydroxypropane-tetraacetic acid, triethylenetetramine-hexaacetic acid, or ethylenediaminetetraacetic acid disodium salt. The rhodamine derivative had a dual purpose in this study: firstly, it was incorporated into the hydrogel to allow the qualitative evaluation of mercury entrapment through its fluorogenic switch-off abilities when sensing Hg2+ ions; secondly, it was used to quantitatively evaluate the level of residual mercury from the decontaminated aqueous solutions, via the UV-Vis technique. The ICP-MS analysis of the hydrogels also confirmed the successful entrapment of mercury inside the hydrogels and a good correlation with the UV-Vis method. [ABSTRACT FROM AUTHOR]

Background: Delamanid and bedaquiline are two of the most recently developed antituberculosis (TB) drugs that have been extensively studied in patients with multidrug-resistant TB. There is currently a need for more potent, less-toxic drugs with novel mechanisms of action that can be used in combination with these newer agents to shorten the duration of treatment as well as prevent the development of drug resistance. Quabodepistat (QBS) is a newly discovered inhibitor of decaprenylphosphoryl-β-D-ribose-2′-oxidase, an essential enzyme for Mycobacterium tuberculosis to synthesize key components of its cell wall. The objective of this study is to evaluate the safety, efficacy, and appropriate dosing of a 4-month regimen of QBS in combination with delamanid and bedaquiline in participants with drug-susceptible pulmonary TB in comparison with the 6-month standard treatment (i.e., rifampicin, isoniazid, ethambutol, and pyrazinamide). Methods: This phase 2b/c, open-label, randomized, parallel group, dose-finding trial will enroll approximately 120 participants (including no more than 15% with human immunodeficiency virus [HIV] coinfection) aged ≥ 18 to ≤ 65 years at screening with newly diagnosed pulmonary drug-sensitive TB from ~8 sites in South Africa. Following a screening period of up to 14 days, eligible participants will be randomized in a ratio of 1:2:2:1 to one of four arms. Randomization will be stratified by HIV status and the presence of bilateral cavitation on a screening chest x-ray. After the end of the treatment period, participants will be followed until 12 months post randomization. The primary efficacy endpoint is the proportion of participants achieving sputum culture conversion in Mycobacteria Growth Indicator Tube by the end of the treatment period. The safety endpoints consist of adverse events, clinical laboratory tests, vital signs, physical examination findings, and electrocardiographic changes. Discussion: QBS's potent bactericidal activity and distinct mechanism of action (compared with other TB drugs currently available for human use) may make it an ideal candidate for inclusion in a novel treatment regimen to improve efficacy and potentially prevent resistance to concomitant TB drugs. This trial will assess the effectiveness, safety, and dosing of a new, shorter, QBS-based, combination anti-TB treatment regimen. Trial status: ClinicalTrials.gov NCT05221502. Registered on February 3, 2022 [ABSTRACT FROM AUTHOR]

The article focuses on evaluating whether remote, automatic monitoring of cough, a cardinal symptom of tuberculosis (TB), could serve as a noninvasive and low-cost biomarker for monitoring treatment response in patients with TB.

Large clinical trials often generate complex and large datasets which need to be presented frequently throughout the trial for interim analysis or to inform a data safety monitory board (DSMB). In addition, reliable and traceability are required to ensure reproducibility in pharmacometric data analysis. A reproducible pharmacometric analysis workflow was developed during a large clinical trial involving 1000 participants over one year testing Bacillus Calmette-Guérin (BCG) (re)vaccination in coronavirus disease 2019 (COVID-19) morbidity and mortality in frontline health care workers. The workflow was designed to review data iteratively during the trial, compile frequent reports to the DSMB, and prepare for rapid pharmacometric analysis. Clinical trial datasets (n = 41) were transferred iteratively throughout the trial for review. An RMarkdown based pharmacometric processing script was written to automatically generate reports for evaluation by the DSMB. Reports were compiled, reviewed, and sent to the DSMB on average three days after the data cut-off, reflecting the trial progress in real-time. The script was also utilized to prepare for the trial pharmacometric analyses. The same source data was used to create analysis datasets in NONMEM format and to support model script development. The primary endpoint analysis was completed three days after data lock and unblinding, and the secondary endpoint analyses two weeks later. The constructive collaboration between clinical, data management, and pharmacometric teams enabled this efficient, timely, and reproducible pharmacometrics workflow. [ABSTRACT FROM AUTHOR]

This study presents the synthesis and characterization of alginate-based nanocomposite peelable films, reinforced by carbon nanofibers (CNFs) decorated with nanoparticles that possess remarkable antimicrobial properties. These materials are suitable for immediate decontamination applications, being designed as fluid formulations that can be applied on contaminated surfaces, and subsequently, they can rapidly form a peelable film via divalent ion crosslinking and can be easily peeled and disposed of. Silver, copper, and zinc oxide nanoparticles (NPs) were synthesized using superficial oxidized carbon nanofibers (CNF-ox) as support. To obtain the decontaminating formulations, sodium alginate (ALG) was further incorporated into the colloidal solutions containing the antimicrobial nanoparticles. The properties of the initial CNF-ox-NP-ALG solutions and the resulting peelable nanocomposite hydrogels (obtained by crosslinking with zinc acetate) were assessed by rheological measurements, and mechanical investigations, respectively. The evaluation of Minimal Inhibitory Concentration (MIC) and Minimal Bactericidal Concentration (MBC) for the synthesized nanoparticles (silver, copper, and zinc oxide) was performed. The best values for MIC and MBC were obtained for CNF-ox decorated with AgNPs for both types of bacterial strains: Gram-negative (MIC and MBC values (mg/L): E. coli—3 and 108; P. aeruginosa—3 and 54) and Gram-positive (MIC and MBC values (mg/L): S. aureus—13 and 27). The film-forming decontaminating formulations were also subjected to a microbiology assay consisting of the time-kill test, MIC and MBC estimations, and evaluation of the efficacity of peelable coatings in removing the biological agents from the contaminated surfaces. The best decontamination efficiencies against Staphylococcus aureus, Escherichia coli, and Pseudomonas aeruginosa varied between 97.40% and 99.95% when employing silver-decorated CNF-ox in the decontaminating formulations. These results reveal an enhanced antimicrobial activity brought about by the synergistic effect of silver and CNF-ox, coupled with an efficient incorporation of the contaminants inside the peelable films. [ABSTRACT FROM AUTHOR]

Large clinical trials often generate complex and large datasets which need to be presented frequently throughout the trial for interim analysis or to inform a data safety monitory board (DSMB). In addition, reliable and traceability are required to ensure reproducibility in pharmacometric data analysis. A reproducible pharmacometric analysis workflow was developed during a large clinical trial involving 1000 participants over one year testing Bacillus Calmette-Guérin (BCG) (re)vaccination in coronavirus disease 2019 (COVID-19) morbidity and mortality in frontline health care workers. The workflow was designed to review data iteratively during the trial, compile frequent reports to the DSMB, and prepare for rapid pharmacometric analysis. Clinical trial datasets (n = 41) were transferred iteratively throughout the trial for review. An RMarkdown based pharmacometric processing script was written to automatically generate reports for evaluation by the DSMB. Reports were compiled, reviewed, and sent to the DSMB on average three days after the data cut-off, reflecting the trial progress in real-time. The script was also utilized to prepare for the trial pharmacometric analyses. The same source data was used to create analysis datasets in NONMEM format and to support model script development. The primary endpoint analysis was completed three days after data lock and unblinding, and the secondary endpoint analyses two weeks later. The constructive collaboration between clinical, data management, and pharmacometric teams enabled this efficient, timely, and reproducible pharmacometrics workflow. [ABSTRACT FROM AUTHOR]

Respiratory tract infections (RTIs) are a burden to global health, but their characterization is complicated by the influence of seasonality on incidence and severity. The Re‐BCG‐CoV‐19 trial (NCT04379336) assessed BCG (re)vaccination for protection from coronavirus disease 2019 (COVID‐19) and recorded 958 RTIs in 574 individuals followed over 1 year. We characterized the probability of RTI occurrence and severity using a Markov model with health scores (HSs) for four states of symptom severity. Covariate analysis on the transition probability between HSs explored the influence of demographics, medical history, severe acute respiratory syndrome‐coronavirus 2 (SARS‐CoV‐2), or influenza vaccinations, which became available during the trial, SARS‐CoV‐2 serology, and epidemiology‐informed seasonal influence of infection pressure represented as regional COVID‐19 pandemic waves, as well as BCG (re)vaccination. The infection pressure reflecting the pandemic waves increased the risk of RTI symptom development, whereas the presence of SARS‐CoV‐2 antibodies protected against RTI symptom development and increased the probability of symptom relief. Higher probability of symptom relief was also found in participants with African ethnicity and with male biological gender. SARS‐CoV‐2 or influenza vaccination reduced the probability of transitioning from mild to healthy symptoms. Model diagnostics over calendar‐time indicated that COVID‐19 cases were under‐reported during the first wave by an estimated 2.76‐fold. This trial was performed during the initial phase of the COVID‐19 pandemic in South Africa and the results reflect that situation. Using this unique clinical dataset of prospectively studied RTIs over the course of 1 year, our Markov Chain model was able to capture risk factors for RTI development and severity, including epidemiology‐informed infection pressure. [ABSTRACT FROM AUTHOR]

The school-to-work transition is one of the trickiest steps in the life cycle of an individual because when young people complete their education and enter the labor market, they have to compete to attain a job while lacking the job experience or skills required by employers. Across European countries, the school-to-work transition shows very different characteristics and durations, stemming from, among other factors, (1) the different provisions of services at the country level to help young people become oriented in the labor market, (2) different historical backgrounds, and even (3) the different capacities of education systems to provide the skills required by employers, despite the efforts to homogenize the national education systems, which started with the Bologna process. In this paper, we aim to compare various programs implemented within formal education at the macro-level in Italy, Moldova, and Latvia, three rather different countries in Europe, that have the goal of helping young people during various stages of this transition. The conclusion we can draw is that each of these countries needs to adopt a coordinated and integrated strategy of reforms aimed at (a) preventing early school drop-outs; (b) incentivizing the attainment of a university degree; (c) reforming school curricula; (d) closing the gap between education systems and labor market requirements; and (e) improving the services that help young people during the school-to-work transition. [ABSTRACT FROM AUTHOR]

In this study, novel materials have been obtained via a dual covalent and ionic crosslinking strategies, leading to the formation of a fully interpenetrated polymeric network with remarkable mechanical performances as drug delivery platforms for dermal patches. The polymeric network was obtained by the free-radical photopolymerization of N-vinylpyrrolidone using tri(ethylene glycol) divinyl ether as crosslinker in the presence of sodium alginate (1%, weight%). The ionic crosslinking was achieved by the addition of Zn2+, ions which were coordinated by the alginate chains. Bentonite nanoclay was incorporated in hydrogel formulations to capitalize on its mechanical reinforcement and adsorptive capacity. TiO2 and ZnO nanoparticles were also included in two of the samples to evaluate their influence on the morphology, mechanical properties and/or the antimicrobial activity of the hydrogels. The double-crosslinked nanocomposite hydrogels presented a good tensile resistance (1.5 MPa at 70% strain) and compression resistance (12.5 MPa at a strain of 70%). Nafcillin was loaded into nanocomposite hydrogel films with a loading efficiency of up to 30%. The drug release characteristics were evaluated, and the profile was fitted by mathematical models that describe the physical processes taking place during the drug transfer from the polymer to a PBS (phosphate-buffered saline) solution. Depending on the design of the polymeric network and the nanofillers included, it was demonstrated that the nafcillin loaded into the nanocomposite hydrogel films ensured a high to moderate activity against S. aureus and S. pyogenes and no activity against E. coli. Furthermore, it was demonstrated that the presence of zinc ions in these polymeric matrices can be correlated with the inactivation of E. coli. [ABSTRACT FROM AUTHOR]

Skin infections are frequently treated via intravenous or oral administration of antibiotics, which can lead to serious adverse effects and may sometimes contribute to the proliferation of resistant bacterial strains. Skin represents a convenient pathway for delivering therapeutic compounds, ensured by the high number of blood vessels and amount of lymphatic fluids in the cutaneous tissues, which are systematically connected to the rest of the body. This study provides a novel, straightforward method to obtain nafcillin-loaded photocrosslinkable nanocomposite hydrogels and demonstrates their performance as drug carriers and antimicrobial efficacy against Gram-positive bacteria. The novel formulations obtained, based on polyvinylpyrrolidone, tri(ethylene glycol) divinyl ether crosslinker, hydrophilic bentonite nanoclay, and/or two types of photoactive (TiO2 and ZnO) nanofillers, were characterized using various analytical methods (transmission electron microscopy (TEM), scanning electron microscopy–energy-dispersive X-ray analysis (SEM-EDX), mechanical tests (tension, compression, and shear), ultraviolet-visible spectroscopy (UV-Vis), swelling investigations, and via specific microbiological assays ("agar disc diffusion method" and "time-kill test"). The results reveal that the nanocomposite hydrogel possessed high mechanical resistance, good swelling abilities, and good antimicrobial activity, demonstrating a decrease in the bacteria growth between 3log10 and 2log10 after one hour of direct contact with S. aureus. [ABSTRACT FROM AUTHOR]

This study presents the synthesis and characterization of novel azido molecules with demonstrated crosslinking ability when used as additives in polymer/fullerene organic solar cells. These compounds derived from fullerenes C60 and C70, or dyes from perylenediimide, perylene and tetraphenylethylene frameworks, bearing a different number of azido groups, are of particular interest to stabilize and increase the thermal stability of the device morphology. In particular, the electro and photoactive dye derivatives allow the introduction of additional functionality with the possibility of extending the absorption domain of the photoactive layer. In addition, and more broadly, such azido crosslinkers could find applications in the field of optoelectronic devices as a simple and cheap strategy to improve the performance and long‐term stability of organic solar cells, perovskites solar cells, or organic light‐emitting diodes. [ABSTRACT FROM AUTHOR]

New functional materials based on bacterial cellulose (BC) grafted with poly(ethylene glycol) PEG derivatives for food packaging applications and a facile method for assessing the degradation rates of the final materials are presented. Two types of materials were obtained by grafting the BC films (BCF), respectively lyophilized BC pellicles (BCL) with three PEG derivatives of different molecular weights through radical polymerization. The BC based polymer materials were characterized by SEM, FT-IR, contact angle measurements, and TGA. Tensile tests and DMA analysis were used to compare the two types of materials in terms of shear-modulus, tensile strength and performance giving suitable information for food packaging applications. A new degradation evaluation method, that we propose herein, offers quantitative information about the degradation process in contrast with the SEM analysis, primarily used in literature, which is not decisive in all cases because it characterizes only small parts of the sample. The degradation rates evidenced that the PEG derivatives of higher molecular weight grafted on the surface of BCF led to an acceleration of the degradation process compared with the pristine samples. A good correlation was obtained between the samples analyzed by SEM after the degradation process and their degradation rates were mathematically determined. [ABSTRACT FROM AUTHOR]

Background: A critical step in tuberculosis (TB) drug development is the Phase 2a early bactericidal activity (EBA) study which informs if a new drug or treatment has short-term activity in humans. The aim of this work was to present a standardized pharmacometric model-based early bactericidal activity analysis workflow and determine sample sizes needed to detect early bactericidal activity or a difference between treatment arms. Methods: Seven different steps were identified and developed for a standardized pharmacometric model-based early bactericidal activity analysis approach. Nonlinear mixed effects modeling was applied and different scenarios were explored for the sample size calculations. The sample sizes needed to detect early bactericidal activity given different TTP slopes and associated variability was assessed. In addition, the sample sizes needed to detect effect differences between two treatments given the impact of different TTP slopes, variability in TTP slope and effect differences were evaluated. Results: The presented early bactericidal activity analysis approach incorporates estimate of early bactericidal activity with uncertainty through the model-based estimate of TTP slope, variability in TTP slope, impact of covariates and pharmacokinetics on drug efficacy. Further it allows for treatment comparison or dose optimization in Phase 2a. To detect early bactericidal activity with 80% power and at a 5% significance level, 13 and 8 participants/arm were required for a treatment with a TTP-EBA0-14 as low as 11 h when accounting for variability in pharmacokinetics and when variability in TTP slope was 104% [coefficient of variation (CV)] and 22%, respectively. Higher sample sizes are required for smaller early bactericidal activity and when pharmacokinetics is not accounted for. Based on sample size determinations to detect a difference between two groups, TTP slope, variability in TTP slope and effect difference between two treatment arms needs to be considered. Conclusion: In conclusion, a robust standardized pharmacometric model-based EBA analysis approach was established in close collaboration between microbiologists, clinicians and pharmacometricians. The work illustrates the importance of accounting for covariates and drug exposure in EBA analysis in order to increase the power of detecting early bactericidal activity for a single treatment arm as well as differences in EBA between treatments arms in Phase 2a trials of TB drug development. [ABSTRACT FROM AUTHOR]

Background: Antibiotic treatments are often associated with a late slowdown in bacterial killing. This separates the killing of bacteria into at least two distinct phases: a quick phase followed by a slower phase, the latter of which is linked to treatment success. Current mechanistic explanations for the in vitro slowdown are either antibiotic persistence or heteroresistance. Persistence is defined as the switching back and forth between susceptible and non-susceptible states, while heteroresistance is defined as the coexistence of bacteria with heterogeneous susceptibilities. Both are also thought to cause a slowdown in the decline of bacterial populations in patients and therefore complicate and prolong antibiotic treatments. Reduced bacterial death rates over time are also observed within tuberculosis patients, yet the mechanistic reasons for this are unknown and therefore the strategies to mitigate them are also unknown. Methods and findings: We analyse a dose ranging trial for rifampicin in tuberculosis patients and show that there is a slowdown in the decline of bacteria. We show that the late phase of bacterial killing depends more on the peak drug concentrations than the total drug exposure. We compare these to pharmacokinetic-pharmacodynamic models of rifampicin heteroresistance and persistence. We find that the observation on the slow phase's dependence on pharmacokinetic measures, specifically peak concentrations are only compatible with models of heteroresistance and incompatible with models of persistence. The quantitative agreement between heteroresistance models and observations is very good (Radj2=0.97). To corroborate the importance of the slowdown, we validate our results by estimating the time to sputum culture conversion and compare the results to a different dose ranging trial. Conclusions: Our findings indicate that higher doses, specifically higher peak concentrations may be used to optimize rifampicin treatments by accelerating bacterial killing in the slow phase. It adds to the growing body of literature supporting higher rifampicin doses for shortening tuberculosis treatments. Author summary: During antibiotic therapy, the rate with which bacteria are eliminated often slows down substantially. This necessitates long treatment duration and increases the risk of relapse after a seemingly successful treatment. The causes of the slowdown can vary depending on the combination of antibiotic and pathogen, and as a result strategies to mitigate this require targeted approaches. Here, we focus on pulmonary tuberculosis (TB) as it is one of the deadliest diseases with a high burden across the globe. Treatment is also exceptionally long–it takes 6 months in the simplest case and still carries a 15% risk of relapse after treatment. Specifically, we investigate different doses of rifampicin which is one of the key antibiotics in standard TB treatment. Higher-than-standard doses of rifampicin are potential strategy to shorten therapy duration. We use mathematical models of rifampicin's effect on bacteria and analyses of clinical trial datasets. We conclude that in rifampicin-treated TB, the likely cause for the observed slowdown is the heterogeneous elimination of different bacterial subpopulations within patients. In concordance with previous studies and the data analysis presented here, we predict that bacterial elimination can be accelerated by higher rifampicin doses. [ABSTRACT FROM AUTHOR]

The increasingly harsher and more complex international and European environmental legislation drives the current development of "greener" energetics materials and munitions. The aerospace and defense industries rely on extensive research in the formulation and scale-up production of polymer-bonded explosives (PBX). In this context, this paper aims to present a versatile method for obtaining "green" PBX formulations based on two high explosives (hexogen (RDX) and octogen (HMX)) and acrylic acid—ethyl acrylate copolymeric binders. This study developed an innovative "eco-friendly" technology for coating the RDX and HMX crystals, allowing straightforward and safer manufacture of PBX, avoiding the use of traditional organic solvents. At the same time, these polymeric binders are soluble in water at a slightly alkaline pH and insoluble at acidic or neutral pH, thus ensuring a safer manipulation of the energetic materials during their entire life cycle and a facile recovery of the explosive in its original shape and morphology in demilitarization. The PBX formulations were characterized via specific analytical tools to evaluate the influence of their composition on the safety and performance characteristics: scanning electron microscopy (SEM), Fourier-transform infrared spectroscopy (FT-IR), alkaline pH solubility tests, differential thermal analysis (DTA), impact sensitivity test (BAM Fall Hammer Test), friction sensitivity test (BAM Friction Test), electrostatic sensitivity test (ESD), vacuum stability test, small scale shock reactivity test (SSRT), detonation velocity test. The "green" PBX formulations obtained through a simple and innovative coating method, based on the polymeric binders' adjustable water solubility, demonstrated remarkable energetic performances and a facile recovery of the explosive crystals by the dissolution of the polymeric binder at pH 11 and 30 °C. [ABSTRACT FROM AUTHOR]

The adhesive bonds that ensure the appropriate mechanical properties for metal joining imply the surface chemical and wetting modification characteristics of the substrates. In this work, matrix-assisted pulsed laser evaporation (MAPLE) was used for the surface modification of Al via the deposition of two chemical compounds, polyvinyl alcohol (PVA) and triethanolamine (TEA), from frozen aqueous solutions. The deposition of the TEA and PVA layers was evidenced by FT-IR, SEM, and AFM analysis. The contact angle measurements evidenced the change in the hydrophilicity of the surface and surface free energies. The performance of the commercial silyl-based polymer adhesive Bison Max Repair Extreme Adhesive® was evaluated by tensile strength measurements. This method led to a change in tensile strength of 54.22% in the case of Al-TEA and 36.34% for Al-PVA compared with the control. This study gives preliminary insights into using MAPLE, for the first time in adhesive applications, as a pretreatment method for Al plates for adhesive bonding reinforcement. [ABSTRACT FROM AUTHOR]

Biomarkers are quantifiable characteristics of biological processes. In Mycobacterium tuberculosis, common biomarkers used in clinical drug development are colony forming unit (CFU) and time-to-positivity (TTP) from sputum samples. This analysis aimed to develop a combined quantitative tuberculosis biomarker model for CFU and TTP biomarkers for assessing drug efficacy in early bactericidal activity studies. Daily CFU and TTP observations in 83 previously patients with uncomplicated pulmonary tuberculosis after 7 days of different rifampicin monotherapy treatments (10-40 mg/kg) from the HIGHRIF1 study were included in this analysis. The combined quantitative tuberculosis biomarker model employed the Multistate Tuberculosis Pharmacometric model linked to a rifampicin pharmacokinetic model in order to determine drug exposure-response relationships on three bacterial sub-states using both the CFU and TTP data simultaneously. CFU was predicted from the MTP model and TTP was predicted through a time-to-event approach from the TTP model, which was linked to the MTP model through the transfer of all bacterial sub-states in the MTP model to a one bacterial TTP model. The non-linear CFUTTP relationship over time was well predicted by the final model. The combined quantitative tuberculosis biomarker model provides an efficient approach for assessing drug efficacy informed by both CFU and TTP data in early bactericidal activity studies and to describe the relationship between CFU and TTP over time. [ABSTRACT FROM AUTHOR]

This study presents the formulation and application of strippable coatings for the entrapment and removal of heavy metals (HMs) and radio nuclides (RNs). The "green" formulations involve the use of a water-based solution consisting of a synthetic biodegradable polymer, polyvinyl alcohol (PVA), together with a natural polymer (sodium alginate) as the polymer matrix and bentonite as the reinforcing agent with cation exchange capacity. Four chelating agents comprising two classical chelating agents (ethylenediaminetetraacetic acid (EDTA), diethylenetriamine-pentaacetic acid (DPTA)) and two "green" chelating agents (iminodisuccinic acid (IDS), 2-phosphonobutane-1,2,4-tricarboxylic acid (PBTC)) were used to evaluate the capacity to remove Cu, Sb, Zn, Sr, Pb, Co, and Hg from the contaminated surfaces. This decontamination method leads to the formation of a solid waste, thus eliminating the need for wastewater treatment. Atomic absorption spectroscopy (AAS), inductively coupled plasma mass spectrometry (ICP-MS), scanning electron microscopy with energy dispersive X-ray spectroscopy (SEM-EDX), and ultraviolet-visible (UV–Vis) spectroscopy were used to comparatively evaluate the decontamination efficacy. EDX elemental mapping confirmed the entrapment of the contaminants inside the polymeric matrix. [ABSTRACT FROM AUTHOR]

The present work describes the synthesis of new versatile polyurea (PU) and polyurethane (PUR) matrices, including different chain extenders, which facilitate the design of distinct, tunable properties, and high-performance derivatives. These polymers can be used for various defense and security applications, such as coatings for ballistic protection, CBRN protection, binders for energetic formulations, etc. Combining aliphatic and aromatic molecules in PU or PUR structures enables the synthesis of polymers with improved and controllable thermo-mechanical properties. Thus, for polyurea synthesis, we utilized two types of polymeric aliphatic diamines and three types of aromatic chain extenders (1,1'-biphenyl-4,4'-diamine, benzene-1,2-diamine, and 1,2-diphenylhydrazine). An analogous method was used to synthesize polyurethane films by employing one polymeric aliphatic polyol and three types of aromatic chain extenders (benzene-1,3-diol, benzene-1,4-diol, and benzene-1,2,3-triol). Subsequently, various analytic techniques (Fourier transform infrared spectroscopy–attenuated total reflectance (FTIR-ATR), single cantilever dynamic mechanical analysis (DMA), thermogravimetric analysis (TGA), frequency-dependent shear modulus survey, tensile tests, water contact angle measurements, and scanning electron microscopy (SEM) with energy-dispersive X-ray analysis (EDX)) have been utilized to characterize the synthesized materials and to evaluate the influence of each chain extender on their final properties. [ABSTRACT FROM AUTHOR]

One of the main strategies for sustainable human society progress is the development of efficient strategies to limit waste production and maximize renewable resource utilization. In this context, this review highlights the opportunity to transform vegetable biomass residues into valuable commercial products. Biomass conversion entails the depolymerization of lignocellulosic biomass towards biopolyols and the synthesis and characterization of the valuable products obtained by using them. The influence of the reaction parameters in both acid and basic catalysis is highlighted, respectively the influence of microwaves on the liquefaction reaction versus conventional heating. Following the depolymerization reaction, polyols are employed to produce polyurethane foams. As a special characteristic, the addition of flame-retardant properties was emphasized. Another interesting topic is the biodegradability of these products, considering the negative consequences that waste accumulation has on the environment. [ABSTRACT FROM AUTHOR]

The environmental impact and availability of ingredients are vital for the new generation of rocket propellants. In this context, several novel composite propellants were prepared based on the "greener" oxidizer phase-stabilized ammonium nitrate (PSAN), a micronized aluminum–magnesium alloy fuel, iron oxide powder burn rate modifier, triethylene glycol dinitrate (TEGDN) energetic plasticizer and a polyurethane (PU) binder. The novelty of this study is brought by the innovative procedure of synthesizing and combining the constituents of these heterogeneous compositions to obtain high-performance "eco-friendly" rocket propellants. The polymorphism shortcomings brought by ammonium nitrate in these energetic formulations have been solved by its co-crystallization with potassium salts (potassium nitrate, potassium chromate, potassium dichromate, potassium sulphate, potassium chlorate and potassium perchlorate). Polyester–polyol blends, resulting from recycled post-consumer polyethylene terephthalate (PET) glycolysis, were utilized for the synthesis of the polyurethane binder, especially designed for this type of application. To adjust the energetic output and tailor the mechanical properties of the propellant, the energetic plasticizer TEGDN was also involved. The performance and safety characteristics of the novel composites were evaluated through various analytical techniques (TGA, DTA, XRD) and specific tests (rate of combustion, heat of combustion, specific volume, chemical stability, sensitivity to thermal, impact and friction stimuli), according to NATO standards, providing promising preliminary results for further ballistics investigations. [ABSTRACT FROM AUTHOR]

There has been an increased interest in pharmacokinetics and pharmacodynamics (PKPD) of anti-tuberculosis drugs. A better understanding of the relationship between drug exposure, antimicrobial kill and acquired drug resistance is essential not only to optimize current treatment regimens but also to design appropriately dosed regimens with new anti-tuberculosis drugs. Although the interest in PKPD has resulted in an increased number of studies, the actual bench-to-bedside translation is somewhat limited. One of the reasons could be differences in methodologies and outcome assessments that makes it difficult to compare the studies. In this paper we summarize most relevant in vitro, in vivo, in silico and human PKPD studies performed to optimize the drug dose and regimens for treatment of tuberculosis. The in vitro assessment focuses on MIC determination, static time-kill kinetics, and dynamic hollow fibre infection models to investigate acquisition of resistance and killing of Mycobacterium tuberculosis populations in various metabolic states. The in vivo assessment focuses on the various animal models, routes of infection, PK at the site of infection, PD read-outs, biomarkers and differences in treatment outcome evaluation (relapse and death). For human PKPD we focus on early bactericidal activity studies and inclusion of PK and therapeutic drug monitoring in clinical trials. Modelling and simulation approaches that are used to evaluate and link the different data types will be discussed. We also describe the concept of different studies, study design, importance of uniform reporting including microbiological and clinical outcome assessments, and modelling approaches. We aim to encourage researchers to consider methods of assessing and reporting PKPD of anti-tuberculosis drugs when designing studies. This will improve appropriate comparison between studies and accelerate the progress in the field. [ABSTRACT FROM AUTHOR]

Radioactive materials are potentially harmful due to the radiation emitted by radionuclides and the risk of radioactive contamination. Despite strict compliance with safety protocols, contamination with radioactive materials is still possible. This paper describes innovative and inexpensive formulations that can be employed as 'eco-friendly' tools for the safe decontamination of radiopharmaceuticals spills or other accidental radioactive contamination of the surfaces arising from general-purpose radioisotope handling facilities (radiopharmaceutical laboratories, hospitals, research laboratories, etc.). These new peelable nanocomposite coatings are obtained from water-based, non-toxic, polymeric blends containing readily biodegradable components, which do not damage the substrate on which they are applied while also displaying efficient binding and removal of the contaminants from the targeted surfaces. The properties of the film-forming decontamination solutions were assessed using rheological measurements and evaporation rate tests, while the resulting strippable coatings were subjected to Fourier-transform infrared spectroscopy (FTIR), thermogravimetric analysis (TGA), differential scanning calorimetry (DSC), and tensile tests. Radionuclide decontamination tests were performed on various types of surfaces encountered in radioisotope workspaces (concrete, painted metal, ceramic tiles, linoleum, epoxy resin cover). Thus, it was shown that they possess remarkable properties (thermal and mechanical resistance which permits facile removal through peeling) and that their capacity to entrap and remove beta and alpha particle emitters depends on the constituents of the decontaminating formulation, but more importantly, on the type of surface tested. Except for the cement surface (which was particularly porous), at which the decontamination level ranged between approximately 44% and 89%, for all the other investigated surfaces, a decontamination efficiency ranging from 80.6% to 96.5% was achieved. [ABSTRACT FROM AUTHOR]

An overview of the different covalent bonding synthetic strategies of two electron acceptors leading to fullerene-perylenediimide (C60-PDI)-based systems, essentially dyads and triads, is presented, as well as their more important applications. To go further in the development of such electron and photoactive assemblies, an original aromatic platform 5-benzyloxy-3-formylbenzoic acid was synthesized to graft both the PDI dye and the fullerene C60. This new C60-PDI dyad exhibits a free anchoring phenolic function that could be used to attach a third electro- and photoactive unit to study cascade electron and/or energy transfer processes or to obtain unprecedented side-chain polymers in which the C60-PDI dyads are attached as pendant moieties onto the main polymer chain. This C60-PDI dyad was fully characterized, and cyclic voltammetry showed the concomitant reduction process onto both C60 and PDI moieties at identical potential. A quasi-quantitative quenching of fluorescence was demonstrated in this C60-PDI dyad, and an intramolecular energy transfer was suggested between these two units. After deprotection of the benzyloxy group, the free hydroxyl functional group of the platform was used as an anchor to reach a new side-chain methyl methacrylate-based polymer in which the PDI-C60 dyad units are located as pendants of the main polymer chain. Such polymer which associates two complementary acceptors could find interesting applications in optoelectronics and in particular in organic solar cells. [ABSTRACT FROM AUTHOR]

Delamanid and bedaquiline are two drugs approved to treat drug‐resistant tuberculosis, and each have been associated with corrected QT interval (QTc) prolongation. We aimed to investigate the relationships between the drugs' plasma concentrations and the prolongation of observed QT interval corrected using Fridericia's formula (QTcF) and to evaluate their combined effects on QTcF, using a model‐based population approach. Furthermore, we predicted the safety profiles of once daily regimens. Data were obtained from a trial where participants were randomized 1:1:1 to receive delamanid, bedaquiline, or delamanid + bedaquiline. The effect on QTcF of delamanid and/or its metabolite (DM‐6705) and the pharmacodynamic interactions under coadministration were explored based on a published model between bedaquiline's metabolite (M2) and QTcF. The metabolites of each drug were found to be responsible for the drug‐related QTcF prolongation. The final drug‐effect model included a competitive interaction between M2 and DM‐6705 acting on the same cardiac receptor and thereby reducing each other's apparent potency, by 28% (95% confidence interval (CI), 22–40%) for M2 and 33% (95% CI, 24–54%) for DM‐6705. The generated combined effect was not greater but close to "additivity" in the analyzed concentration range. Predictions with the final model suggested a similar QT prolonging potential with simplified, once‐daily dosing regimens compared with the approved regimens, with a maximum median change from baseline QTcF increase of 20 milliseconds in both regimens. The concentrations–QTcF relationship of the combination of bedaquiline and delamanid was best described by a competitive binding model involving the two main metabolites. Model predictions demonstrated that QTcF prolongation with simplified once daily regimens would be comparable to currently used dosing regimens. [ABSTRACT FROM AUTHOR]

Background: The WHO-endorsed shorter-course regimen for MDR-TB includes high-dose isoniazid. The pharmacokinetics of high-dose isoniazid within MDR-TB regimens has not been well described.Objectives: To characterize isoniazid pharmacokinetics at 5-15 mg/kg as monotherapy or as part of the MDR-TB treatment regimen.Methods: We used non-linear mixed-effects modelling to evaluate the combined data from INHindsight, a 7 day early bactericidal activity study with isoniazid monotherapy, and PODRtb, an observational study of patients on MDR-TB treatment including terizidone, pyrazinamide, moxifloxacin, kanamycin, ethionamide and/or isoniazid.Results: A total of 58 and 103 participants from the INHindsight and PODRtb studies, respectively, were included in the analysis. A two-compartment model with hepatic elimination best described the data. N-acetyltransferase 2 (NAT2) genotype caused multi-modal clearance, and saturable first-pass was observed beyond 10 mg/kg dosing. Saturable isoniazid kinetics predicted an increased exposure of approximately 50% beyond linearity at 20 mg/kg dosing. Participants treated with the MDR-TB regimen had a 65.6% lower AUC compared with participants on monotherapy. Ethionamide co-administration was associated with a 29% increase in isoniazid AUC.Conclusions: Markedly lower isoniazid exposures were observed in participants on combination MDR-TB treatment compared with monotherapy. Isoniazid displays saturable kinetics at doses >10 mg/kg. The safety implications of these phenomena remain unclear. [ABSTRACT FROM AUTHOR]

Interest in the study of rural tourism and its contribution to the development of rural mountain communities has increased in recent decades. It is recognized that many factors are involved in tourism development, and that residents play a key role in ensuring its success at a local level. This study aims to investigate the perceptions of the inhabitants of the mountainous rural area in the North-East Region of Romania (MRA) towards rural tourism, and to verify whether the development of entrepreneurship in this area is consistent with the positive/negative perceptions identified. A total of 1277 questionnaires were collected from the inhabitants of 78 sampled municipalities, and their processing using statistical methods shows that the inhabitants of two counties have positive perceptions of the living conditions in their communities, the involvement of the authorities in the development of tourism, and the exploitation of tourist attractions. On the other hand, comparing the values of entrepreneurship development indicators shows that two counties concentrate 91% of all active businesses and 94% of newly created businesses in the food and accommodation sector at the level of the study area, and the rate of creation of new businesses and their density have much higher values in these counties than in the county where the analyzed aspects are perceived negatively. The information provided by the research is particularly useful for regional and local authorities to make decisions related to more consistent funding of rural mountain tourism. [ABSTRACT FROM AUTHOR]

We present an automatic non-invasive way of detecting cough events based on both accelerometer and audio signals. The acceleration signals are captured by a smartphone firmly attached to the patient's bed, using its integrated accelerometer. The audio signals are captured simultaneously by the same smartphone using an external microphone. We have compiled a manually-annotated dataset containing such simultaneously-captured acceleration and audio signals for approximately 6000 cough and 68000 non-cough events from 14 adult male patients. Logistic regression (LR), support vector machine (SVM) and multilayer perceptron (MLP) classifiers provide a baseline and are compared with three deep architectures, convolutional neural network (CNN), long short-term memory (LSTM) network, and residual-based architecture (Resnet50) using a leave-one-out cross-validation scheme. We find that it is possible to use either acceleration or audio signals to distinguish between coughing and other activities including sneezing, throat-clearing, and movement on the bed with high accuracy. However, in all cases, the deep neural networks outperform the shallow classifiers by a clear margin and the Resnet50 offers the best performance, achieving an area under the ROC curve (AUC) exceeding 0.98 and 0.99 for acceleration and audio signals respectively. While audio-based classification consistently offers better performance than acceleration-based classification, we observe that the difference is very small for the best systems. Since the acceleration signal requires less processing power, and since the need to record audio is sidestepped and thus privacy is inherently secured, and since the recording device is attached to the bed and not worn, an accelerometer-based highly accurate non-invasive cough detector may represent a more convenient and readily accepted method in long-term cough monitoring. [ABSTRACT FROM AUTHOR]

Background and Objective: Delamanid is a nitroimidazole, a novel class of drug for treating tuberculosis, and is primarily metabolized by albumin into the metabolite DM-6705. The aims of this analysis were to develop a population pharmacokinetic (PK) model to characterize the concentration-time course of delamanid and DM-6705 in adults with drug-resistant tuberculosis and to explore a potential drug–drug interaction with bedaquiline when coadministered. Methods: Delamanid and DM-6705 concentrations after oral administration, from 52 participants (of whom 26 took bedaquiline concurrently and 20 were HIV-1 positive) enrolled in the DELIBERATE trial were analyzed using nonlinear mixed-effects modeling. Results: Delamanid PK were described by a one-compartment disposition model with transit compartment absorption (mean absorption time of 1.45 h [95% confidence interval 0.501–2.20]) and linear elimination, while the PK of DM-6705 metabolite were described by a one-compartment disposition model with delamanid clearance as input and linear elimination. Predicted terminal half-life values for delamanid and DM-6705 were 15.1 h and 7.8 days, respectively. The impact of plasma albumin concentrations on delamanid metabolism was not significant. Bedaquiline coadministration did not affect delamanid PK. Other than allometric scaling with body weight, no patients' demographics were significant (including HIV). Conclusions: This is the first joint PK model of delamanid and its DM-6705 metabolite. As such, it can be utilized in future exposure–response or exposure–safety analyses. Importantly, albumin concentrations, bedaquiline coadministration, and HIV co-infection (dolutegravir coadministration) did not have an effect on delamanid and DM-6705 PK. [ABSTRACT FROM AUTHOR]

This study presents the functionalization and characterization of graphene and electromagnetic interference (EMI) attenuation capacity in epoxy-nanocomposites. The modification of graphene involved both small molecules and polymers for compatibilization with epoxy resin components to provide EMI shielding. The TGA and RAMAN analyses confirmed the synthesis of graphene with a different layer thickness of the graphene sheets. Graphene samples with different layer thicknesses (monolayer, few layers, and multilayer) were selected and further employed for epoxy coating formulation. The obtained nanocomposites were characterized in terms of EMI shielding effectiveness, SEM, micro-CT, magnetic properties, and stress-strain resistance. The EMI shielding effectiveness results indicated that the unmodified graphene and hexamethylene diamine (HMDA) modified graphene displayed the best EMI shielding properties at 11 GHz. However, the epoxy nanocomposites based on HMDA modified graphene displayed better flexibility with an identical EMI shielding effectiveness compared to the unmodified graphene despite the formation of aggregates. The improved flexibility of the epoxy nanocomposites and EMI shielding characteristics of HMDA functionalized graphene offers a practical solution for textile coatings with microwave absorbing (MA) capacity. [ABSTRACT FROM AUTHOR]

Background: With current treatment options most patients with CNS TB develop severe disability or die. Drug-resistant tuberculous meningitis is nearly uniformly fatal. Novel treatment strategies are needed. Bedaquiline, a potent anti-TB drug, has been reported to be absent from CSF in a single report.Objectives: To explore the pharmacokinetics of bedaquiline and its M2 metabolite in the CSF of patients with pulmonary TB.Patients and Methods: Individuals with rifampicin-resistant pulmonary TB established on a 24 week course of treatment with bedaquiline underwent a lumbar puncture along with multiple blood sample collections over 24 h for CSF and plasma pharmacokinetic assessment, respectively. To capture the expected low bedaquiline and M2 concentrations (due to high protein binding in plasma) we optimized CSF collection and storage methods in vitro before concentrations were quantified via liquid chromatography with tandem MS.Results: Seven male participants were enrolled, two with HIV coinfection. Using LoBind® tubes lined with a 5% BSA solution, bedaquiline and M2 could be accurately measured in CSF. Bedaquiline and M2 were present in all patients at all timepoints at concentrations similar to the estimated unbound fractions in plasma.Conclusions: Bedaquiline and M2 penetrate freely into the CSF of pulmonary TB patients with a presumably intact blood-brain barrier. Clinical studies are urgently needed to determine whether bedaquiline can contribute meaningfully to the treatment of CNS TB. [ABSTRACT FROM AUTHOR]

Rationale: Carbapenems are recommended for treatment of drug-resistant tuberculosis. Optimal dosing remains uncertain. Objectives: To evaluate the 14-day bactericidal activity of meropenem, at different doses, with or without rifampin. Methods: Individuals with drug-sensitive pulmonary tuberculosis were randomized to one of four intravenous meropenem-based arms: 2 g every 8 hours (TID) (arm C), 2 g TID plus rifampin at 20 mg/kg once daily (arm D), 1 g TID (arm E), or 3 g once daily (arm F). All participants received amoxicillin/clavulanate with each meropenem dose. Serial overnight sputum samples were collected from baseline and throughout treatment. Median daily fall in colony-forming unit (CFU) counts per milliliter of sputum (solid culture) (EBACFU0-14) and increase in time to positive culture (TTP) in liquid media were estimated with mixed-effects modeling. Serial blood samples were collected for pharmacokinetic analysis on Day 13. Measurements and Main Results: Sixty participants enrolled. Median EBACFU0-14 counts (2.5th-97.5th percentiles) were 0.22 (0.12-0.33), 0.12 (0.057-0.21), 0.059 (0.033-0.097), and 0.053 (0.035-0.081); TTP increased by 0.34 (0.21-0.75), 0.11 (0.052-0.37), 0.094 (0.034-0.23), and 0.12 (0.04-0.41) (log10 h), for arms C-F, respectively. Meropenem pharmacokinetics were not affected by rifampin coadministration. Twelve participants withdrew early, many of whom cited gastrointestinal adverse events. Conclusions: Bactericidal activity was greater with the World Health Organization-recommended total daily dose of 6 g daily than with a lower dose of 3 g daily. This difference was only detectable with solid culture. Tolerability of intravenous meropenem, with amoxicillin/clavulanate, though, was poor at all doses, calling into question the utility of this drug in second-line regimens. Clinical trial registered with www.clinicaltrials.gov (NCT03174184). [ABSTRACT FROM AUTHOR]

Background: Despite the high global disease burden of tuberculosis (TB), the disease caused by Mycobacterium tuberculosis (Mtb) infection, novel treatments remain an urgent medical need. Development efforts continue to be hampered by the reliance on culture-based methods, which often take weeks to obtain due to the slow growth rate of Mtb. The availability of a "real-time" measure of treatment efficacy could accelerate TB drug development. Sputum lipoarabinomannan (LAM; an Mtb cell wall glycolipid) has promise as a pharmacodynamic biomarker of mycobacterial sputum load.Methods: The present analysis evaluates LAM as a surrogate for Mtb burden in the sputum samples from 4 cohorts of a total of 776 participants. These include those from 2 cohorts of 558 non-TB and TB participants prior to the initiation of treatment (558 sputum samples), 1 cohort of 178 TB patients under a 14-day bactericidal activity trial with various mono- or multi-TB drug therapies, and 1 cohort of 40 TB patients with data from the first 56-day treatment of a standard 4-drug regimen.Results: Regression analysis demonstrated that LAM was a predictor of colony-forming unit (CFU)/mL values obtained from the 14-day treatment cohort, with well-estimated model parameters (relative standard error ≤ 22.2%). Moreover, no changes in the relationship between LAM and CFU/mL were observed across the different treatments, suggesting that sputum LAM can be used to reasonably estimate the CFU/mL in the presence of treatment. The integrated analysis showed that sputum LAM also appears to be as good a predictor of time to Mycobacteria Growth Incubator Tube (MGIT) positivity as CFU/mL. As a binary readout, sputum LAM positivity is a strong predictor of solid media or MGIT culture positivity with an area-under-the-curve value of 0.979 and 0.976, respectively, from receiver-operator curve analysis.Conclusions: Our results indicate that sputum LAM performs as a pharmacodynamic biomarker for rapid measurement of Mtb burden in sputum, and thereby may enable more efficient early phase clinical trial designs (e.g., adaptive designs) to compare candidate anti-TB regimens and streamline dose selection for use in pivotal trials. Trial registration NexGen EBA study (NCT02371681). [ABSTRACT FROM AUTHOR]

Copper nanoparticles on silica support are cheap and effective catalysts for dehydrogenation of n-butanol, a biomass-derived building block which is increasingly used. Ultrasonically assisted Cu catalysts are prepared, characterized, and tested for the conversion of n-butanol to n-butanal. The best performance in terms of overall conversion of n-butanol and selectivity to butanal was offered by ultrasound-prepared process of the Cu nanoparticles. In conventional wet impregnation method, Cu nanoparticles on the surface of support tend to aggregate in some sort of cubic aggregates with the size of 4–5 µm and because of this, the percentage of the centers of silica (on which intermolecular dehydration reactions occur) is higher compared to Cu metallic centers (that promotes the dehydrogenation reaction). The ultrasound reduction stage used in the preparation of catalysts provides a better coverage of the catalyst surface by Cu nanoparticles that have a more uniform dimension, which offers a greater selectivity to butanal (more than 95%) and a negligible selectivity to butene. [ABSTRACT FROM AUTHOR]

The political map of Europe underwent numerous changes at the end of the century XVIII, determined by the periods of expansion of the great powers. The agreements regarding the cession of some territories were manifested without the endorsement of the peoples, being only a result of diplomatic activities. One of the important events that has had territorial repercussions so far is the occupation by the Habsburg Empire of a territory in Moldova, with an area of 10,441 km2. The Habsburg Empire introduced numerous reforms in Bukovina, which created a contrast in the humanized landscape with the extrabucovinian territories. The fundamental elements that led to territorial contrasts with the unoccupied proximity: -identification and use of natural resources; -administrative-territorial reform; -increasing the percentage of the literate population; -changing the ethnic and confessional composition. Objectives of the paper: -identification of the geographical features of the Upper Country of Moldova before the Habsburg occupation; -to determine the way in which they were transformed: Bucovina and the extrabucovinean territory from Suceava county between 1775-1918; - to clarify the particularities that created the dynamics in the reform of the two territories; Research methods: -comparative analysis in the temporal evolution of the territories: bucovinean and extrabucovinean from Suceava County; -transformation of historical information into geographical data; -processing and interpretation of statistical data. [ABSTRACT FROM AUTHOR]

Rates of antimicrobial resistance are increasing globally while the pipeline of new antibiotics is drying up, putting patients with disease caused by drug-resistant bacteria at increased risk of complications and death. The growing costs for diagnosis and management of drug resistance threaten tuberculosis control where the disease is endemic and resources limited. Bacteriophages are viruses that attack bacteria. Phage preparations served as anti-infective agents long before antibiotics were discovered. Though small in size, phages are the most abundant and diverse biological entity on earth. Phages have co-evolved with their hosts and possess all the tools needed to infect and kill bacteria, independent of drug resistance. Modern biotechnology has improved our understanding of the biology of phages and their possible uses. Phage preparations are available to treat meat, fruit, vegetables, and dairy products against parasites or to prevent contamination with human pathogens, such as Listeria monocytogenes, Escherichia coli, or Staphylococcus aureus. Such phage-treated products are considered fit for human consumption. A number of recent case reports describe in great detail the successful treatment of highly drug-resistant infections with individualized phage preparations. Formal clinical trials with standardized products are slowly emerging. With its highly conserved genome and relative paucity of natural phage defence mechanisms Mycobacterium tuberculosis appears to be a suitable target for phage treatment. A phage cocktail with diverse and strictly lytic phages that kill all lineages of M. tuberculosis, and can be propagated on Mycobacterium smegmatis, has been assembled and is available for the evaluation of optimal dosage and suitable routes of administration for tuberculosis in humans. Phage treatment can be expected to be safe and active on extracellular organisms, but phage penetration to intracellular and granulomatous environments as well as synergistic effects with antibiotics are important questions to address during further evaluation. [ABSTRACT FROM AUTHOR]

Rationale: There is accumulating evidence that higher-than-standard doses of isoniazid are effective against low-to-intermediate-level isoniazid-resistant strains of Mycobacterium tuberculosis, but the optimal dose remains unknown. Objectives: To characterize the association between isoniazid pharmacokinetics (standard or high dose) and early bactericidal activity against M. tuberculosis (drug sensitive and inhA mutated) and N-acetyltransferase 2 status. Methods: ACTG (AIDS Clinical Trial Group) A5312/INHindsight is a 7-day early bactericidal activity study with isoniazid at a normal dose (5 mg/kg) for patients with drug-sensitive bacteria and 5, 10, and 15 mg/kg doses for patients with inhA mutants. Participants with pulmonary tuberculosis received daily isoniazid monotherapy and collected sputum daily. Colony-forming units (cfu) on solid culture and time to positivity in liquid culture were jointly analyzed using nonlinear mixed-effects modeling. Measurements and Main Results: Fifty-nine adults were included in this analysis. A decline in sputum cfu was described by a one-compartment model, whereas an exponential bacterial growth model was used to interpret time-to-positivity data. The model found that bacterial kill is modulated by isoniazid concentration using an effect compartment and a sigmoidal Emax relationship (a model linking the drug concentration to the observed effect). The model predicted lower potency but similar maximum kill of isoniazid against inhA-mutated compared with drug-sensitive isolates. Based on simulations from the pharmacokinetics-pharmacodynamics model, to achieve a drop in bacterial load comparable to 5 mg/kg against drug-sensitive tuberculosis, 10- and 15-mg/kg doses are necessary against inhA-mutated isolates in slow and intermediate N-acetyltransferase 2 acetylators, respectively. Fast acetylators underperformed even at 15 mg/kg. Conclusions: Dosing of isoniazid based on N-acetyltransferase 2 acetylator status may help patients attain effective exposures against inhA-mutated isolates. Clinical trial registered with www.clinicaltrials.gov (NCT01936831). [ABSTRACT FROM AUTHOR]

This study aimed to develop a facile synthesis procedure for heterogeneous catalysts based on organic guanidine derivatives superbases chemically grafted on silica-coated Fe3O4 magnetic nanoparticles. Thus, the three organosilanes that were obtained by reacting the selected carbodiimides (N,N′-dicyclohexylcarbodiimide (DCC), N,N′-diisopropylcarbodiimide (DIC), respectively 1-ethyl-3-(3-dimethylaminopropyl) carbodiimide (EDC) with 3-aminopropyltriethoxysilane (APTES) were used in a one-pot synthesis stage for the generation of a catalytic active protective shell through the simultaneous hydrolysis/condensation reaction with tetraethyl orthosilicate (TEOS). The catalysts were characterized by FTIR, TGA, SEM, BET and XRD analysis confirming the successful covalent attachment of the organic derivatives in the silica shell. The second aim was to highlight the capacity of microwaves (MW) to intensify the transesterification process and to evaluate the activity, stability, and reusability characteristics of the catalysts. Thus, in MW-assisted transesterification reactions, all catalysts displayed FAME yields of over 80% even after 5 reactions/activation cycles. Additionally, the influence of FFA content on the catalytic activity was investigated. As a result, in the case of Fe3O4@SiO2-EDG, a higher tolerance towards the FFA content can be noticed with a FAME yield of over 90% (for a 5% (weight) vs oil catalyst content) and 5% weight FFA content. [ABSTRACT FROM AUTHOR]

Background Rifampicin (RIF) resistance is highly correlated with isoniazid (INH) resistance and used as proxy for multidrug-resistant tuberculosis (MDR-TB). Using MTBDR plus as a comparator, we evaluated the predictive value of Xpert MTB/RIF (Xpert)–detected RIF resistance for MDR-TB in eastern Democratic Republic of the Congo (DRC). Methods We conducted a cross-sectional study involving data from new or retreatment pulmonary adult TB cases evaluated between July 2013 and December 2016. Separate, paired sputa for smear microscopy and MTBDR plus were collected. Xpert testing was performed subject to the availability of Xpert cartridges on sample remnants after microscopy. Results Among 353 patients, 193 (54.7%) were previously treated and 224 (63.5%) were MTBDR plus TB positive. Of the 224, 43 (19.2%) were RIF monoresistant, 11 (4.9%) were INH monoresistant, 53 (23.7%) had MDR-TB, and 117 (52.2%) were RIF and INH susceptible. Overall, among the 96 samples detected by MTBDR plus as RIF resistant, 53 (55.2%) had MDR-TB. Xpert testing was performed in 179 (50.7%) specimens; among these, 163 (91.1%) were TB positive and 73 (44.8%) RIF resistant. Only 45/73 (61.6%) Xpert-identified RIF-resistant isolates had concomitant MTBDR plus -detected INH resistance. Xpert had a sensitivity of 100.0% (95% CI, 92.1–100.0) for detecting RIF resistance but a positive-predictive value of only 61.6% (95% CI, 49.5–72.8) for MDR-TB. The most frequent mutations associated with RIF and INH resistance were S531L and S315T1, respectively. Conclusions In this high-risk MDR-TB study population, Xpert had low positive-predictive value for the presence of MDR-TB. Comprehensive resistance testing for both INH and RIF should be performed in this setting. [ABSTRACT FROM AUTHOR]

Background and Objective: This study aimed to develop and evaluate a population pharmacokinetic model and limited sampling strategy for isoniazid to be used in model-based therapeutic drug monitoring. Methods: A population pharmacokinetic model was developed based on isoniazid and acetyl-isoniazid pharmacokinetic data from seven studies with in total 466 patients from three continents. Three limited sampling strategies were tested based on the available sampling times in the dataset and practical considerations. The tested limited sampling strategies sampled at 2, 4, and 6 h, 2 and 4 h, and 2 h after dosing. The model-predicted area under the concentration–time curve from 0 to 24 h (AUC24) and the peak concentration from the limited sampling strategies were compared to predictions using the full pharmacokinetic curve. Bias and precision were assessed using the mean error (ME) and the root mean square error (RMSE), both expressed as a percentage of the mean model-predicted AUC24 or peak concentration on the full pharmacokinetic curve. Results: Performance of the developed model was acceptable and the uncertainty in parameter estimations was generally low (the highest relative standard error was 39% coefficient of variation). The limited sampling strategy with sampling at 2 and 4 h was determined as most suitable with an ME of 1.1% and RMSE of 23.4% for AUC24 prediction, and ME of 2.7% and RMSE of 23.8% for peak concentration prediction. For the performance of this strategy, it is important that data on both isoniazid and acetyl-isoniazid are used. If only data on isoniazid are available, a limited sampling strategy using 2, 4, and 6 h can be employed with an ME of 1.7% and RMSE of 20.9% for AUC24 prediction, and ME of 1.2% and RMSE of 23.8% for peak concentration prediction. Conclusions: A model-based therapeutic drug monitoring strategy for personalized dosing of isoniazid using sampling at 2 and 4 h after dosing was successfully developed. Prospective evaluation of this strategy will show how it performs in a clinical therapeutic drug monitoring setting. [ABSTRACT FROM AUTHOR]

Anton Ghon is well known in the field of childhood tuberculosis, and the tuberculosis primary focus and complex are frequently called the Ghon focus and complex; this is largely the result of the wide publication of the English translation of his monograph "Der primäre Lungenherd bei der Tuberkulose der Kinder." Ghon's studies are frequently quoted, but precise details of his monograph are neglected, his results often misquoted, and his later publications virtually unknown. This review highlights aspects of Ghon's anatomical pathology studies in children and adults not necessarily dying of tuberculosis but with signs of tuberculosis infection. Ghon found a single primary tuberculosis focus in approximately 80% of tuberculosis-infected children situated close to the pleura in two-thirds of cases. Cavitation of the focus was common, and lymphatic spread involved lymph nodes in the abdomen and neck in many children. Studies amongst adults and children frequently found the healed primary tuberculosis focus to be completely calcified without histological signs of tuberculosis activity; however, particularly in the presence of pulmonary tuberculosis, histological signs of tuberculosis activity were often found in the lymph nodes of the angulus venosus, despite apparent healing with extensive calcification. Both earlier studies and more recent investigations, with molecular biological tools, unavailable to Ghon and earlier researchers, have confirmed the presence of viable mycobacteria in apparently normal or healed thoracic nodes and also found molecular biological indications of viable mycobacteria in these nodes. As suggested by Ghon, lympho-haematogenous spread of tuberculosis may be more common than is usually appreciated. [ABSTRACT FROM AUTHOR]

Background: Meropenem is being investigated for repurposing as an anti-tuberculosis drug. This study aimed to develop a meropenem population pharmacokinetics model in patients with pulmonary tuberculosis and identify covariates explaining inter-individual variability. Methods: Patients were randomized to one of four treatment groups: meropenem 2 g three times daily plus oral rifampicin 20 mg/kg once daily, meropenem 2 g three times daily, meropenem 1 g three times daily, and meropenem 3 g once daily. Meropenem was administered by intravenous infusion over 0.5–1 h. All patients also received oral amoxicillin/clavulanate together with each meropenem dose, and treatments continued daily for 14 days. Intensive plasma pharmacokinetics sampling over 8 h was conducted on the 14th day of the study. Nonlinear mixed-effects modeling was used for data analysis. The best model was chosen based on likelihood metrics, goodness-of-fit plots, and parsimony. Covariates were tested stepwise. Results: A total of 404 concentration measurements from 49 patients were included in the analysis. A two-compartment model parameterized with clearance (CL), inter-compartmental clearance (Q), and central (V1) and peripheral (V2) volumes of distribution fitted the data well. Typical values of CL, Q, V1, and V2 were 11.8 L/h, 3.26 L/h, 14.2 L, and 3.12 L, respectively. The relative standard errors of the parameter estimates ranged from 3.8 to 35.4%. The covariate relations included in the final model were creatinine clearance on CL and allometric scaling with body weight on all disposition parameters. An effect of age on CL as previously reported could not be identified. Conclusion: A two-compartment model described meropenem population pharmacokinetics in patients with pulmonary tuberculosis well. Covariates found to improve model fit were creatinine clearance and body weight but not rifampicin treatment. The final model will be used for an integrated pharmacokinetics/pharmacodynamics analysis linking meropenem exposure to early bactericidal activity. [ABSTRACT FROM AUTHOR]