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Application of advanced techniques to ensure the environment sustainability and freshwater ecosystem conservation is a paramount importance. Industrial sector is mostly accused for the increased water pressure with high water consumption rates and increased grey water footprints. Industries must take action toward implementing water conservation strategies to enhance natural water cycle, increase water-use efficiency and address future challenges. The significance of water footprint as a driving force to water conservation is spotlighted with severe water scarcity. “Sustainable Development Goals (SDGs)” proposed by the United Nations are focused on creating a sustainable way of life to reduce the impacts on ecology and achieve economic and social benefits. Water is a central part in sustainable development; thus, all SDGs are interlinked with sustainable water use. The paper reviews incorporating the concept of water footprint to achieve SDGs in relation to industrial water conservation and the future pathways that lead to sustainable water resource management.

Elastic electron–proton scattering (e–p) and the spectroscopy of hydrogen atoms are the two methods traditionally used to determine the proton charge radius, r p . In 2010, a new method using muonic hydrogen atoms 1 found a substantial discrepancy compared with previous results 2 , which became known as the ‘proton radius puzzle’. Despite experimental and theoretical efforts, the puzzle remains unresolved. In fact, there is a discrepancy between the two most recent spectroscopic measurements conducted on ordinary hydrogen 3 , 4 . Here we report on the proton charge radius experiment at Jefferson Laboratory (PRad), a high-precision e–p experiment that was established after the discrepancy was identified. We used a magnetic-spectrometer-free method along with a windowless hydrogen gas target, which overcame several limitations of previous e–p experiments and enabled measurements at very small forward-scattering angles. Our result, r p  = 0.831 ± 0.007 stat  ± 0.012 syst  femtometres, is smaller than the most recent high-precision e–p measurement 5 and 2.7 standard deviations smaller than the average of all e–p experimental results 6 . The smaller r p we have now measured supports the value found by two previous muonic hydrogen experiments 1 , 7 . In addition, our finding agrees with the revised value (announced in 2019) for the Rydberg constant 8 —one of the most accurately evaluated fundamental constants in physics. A magnetic-spectrometer-free method for electron–proton scattering data reveals a proton charge radius 2.7 standard deviations smaller than the currently accepted value from electron–proton scattering, yet consistent with other recent experiments.

Background Prescription errors (PE) are more prone to occur in paediatric care due to weight-based dosing and age-specific formulations. The review aims to determine the prevalence of PE, factors associated and strategies employed to mitigate PE in paediatric care. Methodology This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A comprehensive search was conducted in MEDLINE and Cochrane databases using predefined terms related to prescribing errors and pediatric populations. Studies involving individuals under 18 years of age and focusing on prescribing errors in various healthcare settings were included. Two independent reviewers screened citations based on inclusion and exclusion criteria, resolving disagreements through discussion. Data extraction covered study characteristics, prescribing error types, associated factors, and preventive strategies. The quality of included studies was assessed using Allan and Barker’s criteria used in examining PE. Results The review included nine studies. Prevalence of PE varied from 22 to 70%. The most frequent PE type reported was dosing error (five out of nine articles) in both paediatric inpatient and emergency departments, whereas in outpatient settings it was inappropriate abbreviations. Antibiotics emerge as the most frequently implicated drug class. Only two articles have presented associated factors with PE. Parent factors such as poor health literacy ( p  < 0.001), language proficiency ( p  < 0.001), patient variables like age, weight, and other contextual factors including hospital stay, number of medications and medication administration methods were the main factors associated with PE ( p  < 0.05).The interventions that have shown statistically significant effectiveness in reducing PE were implementing e-learning resources, utilizing a color-coded method for dose determination, educating physicians and implementing templated prescriptions ( p  < 0.001). Conclusion This review highlights the high prevalence of prescribing errors in pediatric care, with dosing errors being the most common, particularly in inpatient and emergency settings. Antibiotics were the most frequently implicated drug class. Highlighting the preventable nature of these errors, our analysis confirms the need for further studies on PE focusing on factors affecting prescription errors and targeted interventions to reduce these errors in paediatric care.

Decompression sickness (DCS) is a life-threatening clinical condition that occurs following an uncontrolled rapid ascent after a deep dive, leading to the formation of gas bubbles in the blood occurring due to the rapid decline in environmental pressure. We report the case of a 32-year-old male who presented with bilateral lower limb numbness eight hours following a diving session. He was diagnosed with neurological DCS and transported 365 km to the Naval Hospital, Eastern Command where he received hyperbaric oxygen treatment and made a full recovery. This individual developed DCS after repetitive dives within a week despite having planned ascents with advice from a diving instructor. He switched between different rented diving computers; consequently, these devices lacked cumulative dive history to indicate minimum surface time required for sufficient nitrogen gas washout. Both the diver and instructors had a suboptimal assessment of the cumulative dive exposure and worked with a false reassurance of having planned ascents under supervision. In addition, this report highlights critical delays in the diagnosis of DCS and complexities involved in accessing the country's only hyperbaric treatment facility. It also emphasizes the need for empowering diving centers and medical professionals for early identification and facilitating access to prompt treatment.

Background Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) causes coronavirus disease 2019 (COVID-19) through direct lysis of infected lung epithelial cells, which releases damage-associated molecular patterns and induces a pro-inflammatory cytokine milieu causing systemic inflammation. Anti-viral and anti-inflammatory agents have shown limited therapeutic efficacy. Soluble CD24 (CD24Fc) blunts the broad inflammatory response induced by damage-associated molecular patterns via binding to extracellular high mobility group box 1 and heat shock proteins, as well as regulating the downstream Siglec10-Src homology 2 domain–containing phosphatase 1 pathway. A recent randomized phase III trial evaluating CD24Fc for patients with severe COVID-19 (SAC-COVID; NCT04317040) demonstrated encouraging clinical efficacy. Methods Using a systems analytical approach, we studied peripheral blood samples obtained from patients enrolled at a single institution in the SAC-COVID trial to discern the impact of CD24Fc treatment on immune homeostasis. We performed high dimensional spectral flow cytometry and measured the levels of a broad array of cytokines and chemokines to discern the impact of CD24Fc treatment on immune homeostasis in patients with COVID-19. Results Twenty-two patients were enrolled, and the clinical characteristics from the CD24Fc vs. placebo groups were matched. Using high-content spectral flow cytometry and network-level analysis, we found that patients with severe COVID-19 had systemic hyper-activation of multiple cellular compartments, including CD8 + T cells, CD4 + T cells, and CD56 + natural killer cells. Treatment with CD24Fc blunted this systemic inflammation, inducing a return to homeostasis in NK and T cells without compromising the anti-Spike protein antibody response. CD24Fc significantly attenuated the systemic cytokine response and diminished the cytokine coexpression and network connectivity linked with COVID-19 severity and pathogenesis. Conclusions Our data demonstrate that CD24Fc rapidly down-modulates systemic inflammation and restores immune homeostasis in SARS-CoV-2-infected individuals, supporting further development of CD24Fc as a novel therapeutic against severe COVID-19.

Microalgae readily develop tolerance against environmental pollutants and are also capable of utilizing heavy metals in their metabolic activities. Microalgae-based heavy metal removal provides an eco-friendly, cost-effective technology to treat wastewater. In this study, a strain of the green alga Chlorococcum aquaticum, isolated from water polluted with Pb2+, was selected for bioremediation of Pb2+ in aqueous solutions. Chlorococcus aquaticum showed a high level of tolerance toward Pb2+ with an LC50 of 100 mg L−1. To assess the efficacy and practicality of the bioremediation process, adsorption isotherms and kinetic models were developed. The best-fitted adsorption model was Freundlich isotherm with the adsorption constant (KF) = 2.18 mg g−1 and n = 1.01, suggesting a multilayer adsorption to heterogeneous surfaces. The kinetic studies revealed that the interaction of Pb2+ with C. aquaticum obeys pseudo second-order kinetics with the rate constant (k′) = 1.21 × 10−5 g mg−1 min−1 and the amounts of Pb2+ adsorbed per gram of adsorbent at equilibrium (qe) = 500 mg g−1, indicating that the rate determining step involves a chemical reaction mechanism. Chlorococcum aquaticum showed a high tolerance toward Pb2+, high adsorption capacity and a moderate adsorption rate. Thus, growing C. aquaticum can be identified as a potential environmentally friendly and low-cost sorbent to remove a wide range of Pb2+concentrations from wastewater.

Micronutrient deficiencies are mostly hidden; clinically less visible compared to macronutrient deficiencies. Food fortification with multiple micronutrients (MMN) is provided for children between 6–23 months, daily for two months at three-time points. We assessed the acceptance and adherence of this nutritional intervention in an urban community setting in Sri Lanka. This cross-sectional study enrolled caregivers of children aged 7 to 23 months with a cluster sampling method. Caregivers ’ acceptance of taste and smell, health gains, ease of use, and need perception (Cronbach’s reliability: 0.801) were assessed. Also, anemia knowledge (Cronbach’s reliability: 0.642), MMN knowledge, and reported adherence (number of sachets consumed per month) were evaluated through a self-administered questionnaire. Adequate adherence was defined as the use of ≥80% sachets. The univariate and multivariate statistical analysis examined the association of acceptability, adherence, and anemia knowledge with independent variables (socio-demographic, household characteristics, and knowledge). The survey included 153 respondents. The Median (range) age of children was 12 months (7–23). The mean (SD) acceptability score was 66.82% (9.78%). Acceptance of sensory qualities (smell/taste) had a lower score than perceived health benefit. Most consumed MMN adequately (72.5%). The mean (SD) anemia knowledge score was 62.20% (25.79%). In multivariate analysis, child’s age (OR: -0.360, 95% CI:-0.510,-0.211) and father’s education (OR: 2.148, 95% CI: 0.439, 3.857) were independently associated with acceptability. Child’s age (OR: -0.108, 95% CI:0.818, 0.985), anemia knowledge (OR:0.016, 95% CI: 1.003, 1.031) and acceptability (OR:0.236, 95% CI:1.140, 1.406) were significant determinants of adherence. Anemia knowledge was significantly associated with the mother’s education and household income when adjusted. In conclusion, unpleasant smell/taste and daily schedule were reported as barriers to MMN use. Yet, perception and trust regarding health benefits were encouraging. Reported adherence was somewhat high. Improving acceptability and anemia knowledge could enhance adherence further in this population.

Background Circulating immune cells play a crucial role in the anti-tumour immune response, yet the systemic immune system in metastatic breast cancers is not fully characterised. Investigating the cellular and molecular changes in peripheral blood mononuclear cells (PBMCs) from breast cancer patients could elucidate the role of circulating immune cells in metastasis and aid in identifying biomarkers for disease burden and progression. Methods In this study, we characterised the systemic immune landscape associated with varying levels of metastatic burden by analysing the single-cell transcriptomes of PBMCs from breast cancer patients and healthy controls. Our research focused on identifying changes in immune cell composition, transcriptional programs, and immune-cell communication networks linked to metastatic burden. Additionally, we compared these PBMC features onto a single-cell atlas of primary breast tumours to study corresponding traits in tumour-infiltrating immune cells. Results In metastatic breast cancer, PBMCs exhibit a significant downregulation of the adaptive immune system and a decreased number and activity of unconventional T cells, such as γδ T cells. Additionally, metastatic burden is associated with impaired cell communication pathways involved in immunomodulatory functions. We also identified a gene signature derived from myeloid cells shared between tumour immune infiltrates and circulating immune cells in breast cancer patients. Conclusions Our study provides a comprehensive single-cell molecular profile of the peripheral immune system in breast cancer, offering a valuable resource for understanding metastatic disease in terms of tumour burden. By identifying immune traits linked to metastasis, we have unveiled potential new biomarkers of metastatic disease.

Background Identification of internationally comparable indicators of medicines use are important for a country to implement strategies and regulations to improve usage of medicines. Sri Lanka established a new National Medicines Regulatory Authority in 2015 and this survey evaluated the medication use indicators in Sri Lanka, according to the International Network on Rational Use of Drugs (INRUD), prior to its implementation. Methods This descriptive-cross-sectional study was conducted in 80 pharmacies, representing all 25 districts of the country. Three pharmacy categories were included; privately owned pharmacies, ‘Rajya Osusala’ pharmacies operated by the State Pharmaceuticals Corporation (SPC) of Sri Lanka and SPC Franchisee pharmacy outlets. Selection of pharmacies from respective districts were done proportionate to estimated population. Data were collected to identify WHO/INRUD core drug use indicators and the commonly prescribed medicines. Results Total of 2328 prescriptions were included (‘Rajya Osusala 559; SPC Franchise 711; private pharmacies 1058). Altogether 7,255 medicines were prescribed, and the 3 most commonly prescribed medicines were atorvastatin, losartan and metformin. Average number of medicines per encounter was 3.1±1.9 (Median: 3; range 1-12) Highest average number of medicines per encounter was reported in prescriptions received at ‘Rajya Osusala’ pharmacies (3.6±2.2), significantly higher than in other categories of pharmacies ( p <0.001). Percentage of medicines prescribed by generic name was only 35.5%, highest at the ‘Rajya Osusala’ pharmacies (40.6%), significantly higher than other categories of pharmacies. The overall percentage of medicines prescribed from essential medicine list (EML) was 68.8%, without any significant variation between different categories of pharmacies. The percentage of medicines actually dispensed and accurately labelled were 92.4 and 98.5% respectively. Conclusions The average number of medicines per encounter was higher than the WHO recommended value but the usage of antibiotic and injectable drugs were within recommended standards. Generic prescribing, was very much lower. The EML prescribing, labelling and percentage dispensed medicines fared much better although lower than the WHO recommended 100% compliance. This island wide study has provided national wide data before the implementation of key changes in regulation of medicines in Sri Lanka and a repeat survey will be useful to identify impact of the new legislations.

Live oral rotavirus vaccines (LORVs) have significantly reduced rotavirus hospitalizations and deaths worldwide. However, LORVs are less effective in low- and middle-income countries (LMICs). Next-generation rotavirus vaccines (NGRVs) may be more effective but require administration by injection or a neonatal oral dose, adding operational complexity. Healthcare providers (HPs) were interviewed to assess rotavirus vaccine preferences and identify delivery issues as part of an NGRV value proposition. Determine HP vaccine preferences about delivering LORVs compared to injectable (iNGRV) and neonatal oral (oNGRV) NGRVs. 64 HPs from Ghana, Kenya, Malawi, Peru, and Senegal were interviewed following a mixed-method guide centered on three vaccine comparisons: LORV vs. iNGRV; LORV vs. oNGRV; oNGRV vs. iNGRV. HPs reviewed attributes for each vaccine in the comparisons, then indicated and explained their preference. Additional questions elicited views about co-administering iNGRV+LORV for greater public health impact, a possible iNGRV-DTP-containing combination vaccine, and delivering neonatal doses. Almost all HPs preferred oral vaccine options over iNGRV, with many emphasizing an aversion to additional injections. Despite this strong preference, HPs described challenges delivering oral doses. Preferences for LORV vs. oNGRV were split, marked by disparate views on rotavirus disease epidemiology and the safety, need, and feasibility of delivering neonatal vaccines. Although overwhelmingly enthusiastic about an iNGRV-DTP-containing combination option, several HPs had concerns. HP views were divided on the feasibility of co-administering iNGRV+LORV, citing challenges around logistics and caregiver sensitization. Our findings provide valuable insights on delivering NGRVs in routine immunization. Despite opposition to injectables, openness to co-administering LORV+iNGRV to improve efficacy suggests future HP support of iNGRV if adequately informed of its advantages. Rationales for LORV vs. oNGRV underscore needs for training on rotavirus epidemiology and stronger service integration. Expressed challenges delivering existing LORVs merit further examination and indicate need for improved delivery.