Hyaluronic acid (HA) is a widely used dermal filler for soft tissue augmentation. We described a case of a 38-year-old transwoman who presented with sudden onset of severe respiratory distress following self-injection of HA dermal filler. She developed multiple episodes of pulmonary haemorrhage, and her chest X-ray showed diffuse ground-glass opacities consistent with diffuse alveolar haemorrhage (DAH). There were no relevant drugs or past medical histories. Anti-nuclear antibodies and rheumatoid factor were negative. Initially, the pulmonary haemorrhage episodes and ventilation requirement improved with systemic steroid, however she subsequently developed acute myocardial infarction with progressive clinical deterioration leading to death. To the best of our knowledge, this is the first HA-related DAH with myocardial infarction reported with a fatal outcome. This case highlights the importance of awareness and the necessity of having a high suspicion of DAH in patients with history of illicit HA dermal filler use.
This study investigated the feasibility of integrated ammonium stripping and/or coconut shell waste-based activated carbon (CSWAC) adsorption in treating leachate samples. To valorize unused biomass for water treatment application, the adsorbent originated from coconut shell waste. To enhance its performance for target pollutants, the adsorbent was pretreated with ozone and NaOH. The effects of pH, temperature, and airflow rate on the removal of ammoniacal nitrogen (NH3-N) and refractory pollutants were studied during stripping alone. The removal performances of refractory compounds in this study were compared to those of other treatments previously reported. To contribute new knowledge to the field of study, perspectives on nutrients removal and recovery like phosphorus and nitrogen are presented. It was found that the ammonium stripping and adsorption treatment using the ozonated CSWAC attained an almost complete removal (99%) of NH3-N and 90% of COD with initial NH3-N and COD concentrations of 2500 mg/L and 20,000 mg/L, respectively, at optimized conditions. With the COD of treated effluents higher than 200 mg/L, the combined treatments were not satisfactory enough to remove target refractory compounds. Therefore, further biological processes are required to complete their biodegradation to meet the effluent limit set by environmental legislation. As this work has contributed to resource recovery as the driving force of landfill management, it is important to note the investment and operational expenses, engineering applicability of the technologies, and their environmental concerns and benefits. If properly managed, nutrient recovery from waste streams offers environmental and socio-economic benefits that would improve public health and create jobs for the local community.
Floods are one of the most devastating types of disasters that cause loss of lives and property worldwide each year. This study aimed to evaluate and compare the prediction capability of the naïve Bayes tree (NBTree), alternating decision tree (ADTree), and random forest (RF) methods for the spatial prediction of flood occurrence in the Quannan area, China. A flood inventory map with 363 flood locations was produced and partitioned into training and validation datasets through random selection with a ratio of 70/30. The spatial flood database was constructed using thirteen flood explanatory factors. The probability certainty factor (PCF) method was used to analyze the correlation between the factors and flood occurrences. Consequently, three flood susceptibility maps were produced using the NBTree, ADTree, and RF methods. Finally, the area under the curve (AUC) and statistical measures were used to validate the flood susceptibility models. The results indicated that the RF method is an efficient and reliable model in flood susceptibility assessment, with the highest AUC values, positive predictive rate, negative predictive rate, sensitivity, specificity, and accuracy for the training (0.951, 0.892, 0.941, 0.945, 0.886, and 0.915, respectively) and validation (0.925, 0.851, 0.938, 0.945, 0.835, and 0.890, respectively) datasets.
Over the past years, Indonesia, the world's fourth most populous country, has confronted environmental problems due to uncontrolled generation of municipal solid waste (MSW). While the integrated solid waste management (ISWM) represents a critical strategy for Indonesia to control its production, it is also recognized that economic approaches also need to be promoted to address the waste problem concertedly. In this case study, empirical approaches are developed to understand how a volume-based waste fee could be incorporated into MSW collection services and how to apply a zero-waste approach in Indonesia by adapting resource recovery initiatives, adapted from Germany's mature experiences in integrating the CE paradigm into the latter's MSWM practices. Currently, Sukunan village (Yogyakarta, Indonesia) promotes waste reduction at sources in the framework of community-based solid waste management (CBSWM) by mobilizing the local community for waste separation (organic and non-organic) and waste recycling. As a result, about 0.2 million Mt of CO2-eq emissions was avoided annually from local landfills. The economic benefits of recycling activities by the village's community also resulted in 30% reduction of the waste generated. This CBSWM scheme not only saves the government budget on waste collection, transport and disposal, but also extends the lifetime of local landfills as the final disposal sites. By integrating the CE paradigm into its MSWM practices through the implementation of economic instruments and adherence to the rule of law in the same way as Germany does, Indonesia could make positive changes to its environmental policy and regulation of MSW. A sound MSWM in Indonesia could play important roles in promoting the effectiveness of urban development with resource recovery approaches to facilitate its transition towards a CE nationwide in the long-term.
The humpback puffer, Tetraodon palembangensis, is a poisonous freshwater pufferfish species mainly distributed in Southeast Asia (Thailand, Laos, Malaysia and Indonesia). The humpback puffer has many interesting biological features, such as inactivity, tetrodotoxin production and body expansion. Here, we report the first chromosome-level genome assembly of the humpback puffer. The genome size is 362 Mb, with a contig N50 value of ∼1.78 Mb and a scaffold N50 value of ∼15.8 Mb. Based on this genome assembly, ∼61.5 Mb (18.11%) repeat sequences were identified, 19,925 genes were annotated, and the function of 90.01% of these genes could be predicted. Finally, a phylogenetic tree of ten teleost fish species was constructed. This analysis suggests that the humpback puffer and T. nigroviridis share a common ancestor 18.1 million years ago (MYA), and diverged from T. rubripes 45.8 MYA. The humpback puffer genome will be a valuable genomic resource to illustrate possible mechanisms of tetrodotoxin synthesis and tolerance.