The biomass harvested from the constructed wetland was used as fodder for the livestock. A net additional income of Rs.70,000 (∼US$1,000) was realized by the farmers using the treated wastewater for cultivation. Similar constructed wetland-based wastewater management system can be scaled up across water scarce semi-arid tropics. Novelty statementField-scale performance evaluation of constructed wetland based wastewater treatment in a semi-arid tropic village is scarce in the literature. The work presented gives a feasibility assessment for this technology critical for its wide-scale application to augment rural wastewater management in resource poor villages.Aim Two peptide cocktail vaccines using glypican-3, WD-repeat-containing protein up-regulated in hepatocellular carcinoma (HCC) and nei endonuclease VIII-like three epitopes were evaluated in advanced HCC in two Phase I studies.  https://www.selleckchem.com/products/amenamevir.html  Patients & methods Study 1 evaluated dose-limiting toxicities (DLTs) of peptides 1-3 (HLA-A24-restricted) and study 2 evaluated DLTs of peptides 1-6 (HLA-A24 or A02-restricted). Results Overall, 18 and 14 patients were enrolled in studies 1 and 2, respectively. No DLTs were observed up to 7.1 mg of the vaccine cocktail. No complete response/partial response was observed. Stable disease was reported in nine and five patients with a disease control rate of 52.9% and 35.7% in studies 1 and 2, respectively. Conclusion Both vaccines showed good tolerability and potential usefulness against HCC. Clinical trial registration JapicCTI-121933; JapicCTI-142477.Background The aim of this study was to investigate whether increased severity of coronary artery calcium (CAC), an imaging biomarker of subclinical coronary atherosclerosis, is associated with worse cognitive function independent of cardiovascular risk factors in a large population-based Dutch cohort with broad age range. Methods and Results A cross-sectional analysis was performed in 4988 ImaLife participants (aged 45-91 years, 58.3% women) without history of cardiovascular disease. CAC scores were obtained using nonenhanced cardiac computed tomography scanning. The CogState Brief Battery was used to assess 4 cognitive domains processing speed, attention, working memory, and visual learning based on detection task, identification task, 1-back task, and 1-card-learning task, respectively. Differences in mean scores of each cognitive domain were compared among 4 CAC categories (0, 1-99, 100-399, ≥400) using analysis of covariates to adjust for classical cardiovascular risk factors. Age-stratified analysis (45-54, 55-64, and ≥65 years) was performed to assess whether the association of CAC severity with cognitive function differed by age. Overall, higher CAC was associated with worse performance on 1-back task after adjusting for classical cardiovascular risk factors, but CAC was not associated with the other cognitive tasks. Age-stratified analyses revealed that the association of CAC severity with working memory persisted in participants aged 45 to 54 years, while in the elderly this association lost significance. Conclusions In this Dutch population of ≥45 years, increased CAC severity was associated with worse performance of working memory, independent of classical cardiovascular risk factors. The inverse relationship of CAC score categories with working memory was strongest in participants aged 45 to 54 years.
  Tobacco use is a causative or exacerbating risk factor for benign and malignant urological disease. However, it is not well known how often urologists screen for tobacco use and provide tobacco cessation treatment at the population level. We sought to evaluate how often urologists see patients for tobacco-related diagnoses in the outpatient setting and how often these visits include tobacco use screening and treatment.
 
  We used the National Ambulatory Medical Care Survey public use files for the years 2014-2016 to identify all outpatient urology visits with adults 18 years old or older. Clinic visit reasons were categorized according to diagnoses associated with the encounter all urological diagnoses, a tobacco-related urological condition or a urological cancer. Our primary outcome was the percentage of visits during which tobacco screening was reported. Secondary outcomes included reported delivery of cessation counseling and provision of cessation pharmacotherapy.
 
  We identified 4,625 unique urologicalbacco. However, urologists rarely offer counseling or cessation treatment. These findings may represent missed opportunities to decrease the morbidity associated with tobacco use.
  Parasacral transcutaneous electrical nerve stimulation has been used to manage lower urinary tract symptoms refractory to standard urotherapy. Nevertheless, its actual effectiveness in treatment of bladder and bowel dysfunction remains to be established. We sought to evaluate the effectiveness of parasacral transcutaneous electrical nerve stimulation in the treatment of children with bladder and bowel dysfunction.
 
  This was a randomized clinical trial conducted with children and adolescents of 5-17 years of age diagnosed with bladder and bowel dysfunction. Patients with neurological or anatomical abnormalities of urinary or digestive tracts, those unable to attend treatment sessions 3 times a week, individuals with diabetes mellitus or diabetes insipidus and those using anticholinergic drugs or laxatives were excluded from the study. The sample was divided into 2 groups a control group submitted to standard urotherapy plus sham electrotherapy applied to the scapular region and a treatment group submitted tdder and bowel dysfunction in children and adolescents, particularly insofar as functional constipation is concerned.
 Parasacral transcutaneous electrical nerve stimulation is effective for treatment of bladder and bowel dysfunction in children and adolescents, particularly insofar as functional constipation is concerned.
  While the true incidence of secondary hypospadias repair is unknown, the current literature cites a 3.3% to 6.7% reoperation rate after distal hypospadias repair and an association with age. We hypothesized that secondary surgery rates are associated with patient factors and have been underreported due to limited followup.
 
  We used an academic practice plan consortium database to identify a population that underwent primary hypospadias repair in 2009 and 2010. Secondary surgeries between 2009 and 2019 were captured. The association of variables such as age, insurance type, region, surgeon volume and surgeon years in practice with all-inclusive and specific secondary surgery procedures were analyzed using mixed effects multiple logistic regression models.
 
  We identified 5,178 boys who had primary hypospadias repair performed by 84 pediatric urologists at 46 hospitals in 2009 and 2010. During the ensuing 9 to 10 years, distal, proximal and perineal hypospadias repair had a 12.6%, 37.9% and 46.6% rate of secondary surgery, respectively.