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This study assessed the single- and multiple-dose pharmacokinetics of 3 doses (15 mg, 30 mg, and 45 mg) of pioglitazone in 36 adolescents with type 2 diabetes. Blood samples were obtained over a 48-hour interval after the first dose (day 1) and over a 72-hour interval after the last dose (day 15) of pioglitazone and were assayed for pioglitazone and active metabolites (M-III and M-IV). Pioglitazone systemic exposure increased dose dependently but was less than dose proportional during multiple dosing. The median peak pioglitazone concentration occurred at 2 hours. The mean half-life was 8 to 9 hours for pioglitazone and 24 to 32 hours for M-III and M-IV, with similar values at each dose level. During multiple dosing, accumulation for pioglitazone was negligible, but it reached 2.5- to 3.0-fold for M-III and M-IV. The sustained total serum concentration of active compounds during multiple dosing provides the basis for once-daily dose administration of pioglitazone in adolescents. [ABSTRACT FROM AUTHOR]

Children sadly have been excluded from some of the therapeutic advances that have marked pharmaceutical drug development during the past 100 years. Most drugs in use today lack Food and Drug Administration approval for use in children or are restricted to certain pediatric age groups, predominantly older than 12 years. Only a few of the new drugs approved each year have pediatric indications and dosing guidelines described in the drug labeling information. However, many of these drugs are used in children. The lack of suitable information places children at risk for over- or underdosing, and there is a lack of suitable dosage forms, which can result in improper drug administration. This lack of information on the safe and effective use of drugs in the most vulnerable patients--infants and neonates--is of greatest concern. Recent changes in the regulations that govern drug development has dramatically increased the number of drugs that undergo testing in children. This article reviews new laws that govern drug testing in children and the use of children in therapeutic research. [ABSTRACT FROM AUTHOR]

The authors studied the pharmacokinetics of sumatriptan nasal spray after a single dose in children migraineurs outside of migraine attack. Seventeen subjects (9 females) ages 6 to 11 years were given one dose of sumatriptan nasal spray based on age and weight; children 6 to 8 years of age weighing 25 kg and children ages 9 to 11 years of age weighing 40 kg received 20 mg (n = 4). Plasma sumatriptan concentrations were determined in serial blood samples obtained over 8 hours. Pharmacokinetic analysis included both noncompartmental and population modeling methods. The pharmacokinetic parameter estimates (geometric mean [95% confidence interval]) following 5, 10, and 20 mg sumatriptan were, respectively, as follows: maximum concentration = 8.1 ng/mL (3.6-18.4), 10.8 ng/mL (7.7-15.4), and 12.3 ng/mL (7.6-19.9); half-life = 1.4 hours (1.2-1.8), 1.7 hours (1.4-2.0), and 1.7 hours (1.3-2.3); and AUC = 27.8 ng*h/mL (9.7-79.8), 42.4 ng*h/mL (30.6-58.8), and 49.2 ng*h/mL (32.9-73.7). The median time to maximum concentration for all groups was 2 hours. Population pharmacokinetic modeling included pooled data from this study and from an adolescent study (n = 16). Clearance (CL/F) was 197 L/h for a 30-kg child with between-subject variability of 28%, and the volume of distribution was 751 L, normalized for an 11-year-old child with variability of 43%. The covariate analysis showed that volume increases with age and clearance increases with body size. The absorption was complex, often displaying double-peak plasma concentrations, with a rapid absorption phase and a delayed and rate-limited absorption phase. The dosing scheme based on age and weight resulted in maximal concentrations (C(max)) and systemic exposure (AUC) that were comparable to those observed in adolescents and adults treated with 20 mg. The age- and weight-adjusted dosing scheme appears to an appropriate initial dosing regimen for children with migraine headache. Appropriate safety and efficacy trials will need to be completed in children prior to recommending its use in children. [ABSTRACT FROM AUTHOR]

Sumatriptan is a potent and selective vascular 5-HT1 receptor agonist effective for the treatment of migraine. In adults, intranasal sumatriptan is well absorbed and tolerated. The authors evaluated the pharmacokinetics and tolerability of a single dose of 20 mg intranasal sumatriptan in healthy adolescent migraineurs ages 12 to 17 years, administered outside of migraine attack. Serum sumatriptan levels were measured by high-performance liquid chromatography (HPLC) with electrochemical detection in serial samples collected over 8 hours. Physical exam, vital signs, clinical laboratory tests, and electrocardiogram measurements were monitored to assess safety and tolerability. A total of 16 subjects (10 males and 6 females) had pharmacokinetic data that could be analyzed, 2 withdrew from the study 30 and 60 minutes after dosing following the loss of venous access for blood sampling, and a bioanalysis failure resulted in loss of data from 3 subjects. Noncompartmental pharmacokinetic parameters (geometric mean and 95% confidence interval) for the remaining 16 subjects were as follows: Cmax was 13.9 (11.0, 17.6) ng/mL, AUC infinity was 57.3 (47.6, 69.0) ng/mL.h, and t1/2 was 2.0 (1.8, 2.3) hours. Population pharmacokinetic analysis for all subjects (n = 21) showed that clearance and volume of distribution increase slightly with age and body size, but the changes were minimal and would not warrant dose adjustment: CL/F was 316 L (coefficient of variance [CV] = 25%) and Vd/F was 1070 L (CV = 46%). Sumatriptan was well tolerated with only minor adverse events reported, which all resolved spontaneously. The pharmacokinetic parameters in these adolescent subjects were similar to those previously reported in adults, suggesting that adolescents should be dosed similar to adults. [ABSTRACT FROM AUTHOR]

Naratriptan is a novel 5-HT1 agonist developed to treat acute migraine. The study objective was to characterize the pharmacokinetics of oral naratriptan in adolescent migraine patients outside a migraine attack. Subjects received a single 2.5 mg naratriptan tablet. Serial serum samples for naratriptan concentrations were collected over 24 hours. Blood pressure, pulse rate, and 12-lead ECG were recorded at baseline and at regular intervals after dosing. Seven patients--3 males and 4 females, 12 to 16 years of age--received drug and completed the study. The geometric mean and 95% confidence interval maximum concentration (Cmax) was 8.0 ng/mL (5.9-10.7), elimination half-life (t1/2) was 4.9 hours (4.5-5.4), area under the concentration-time curve (AUC) was 74.6 ng.h/mL (56.6-98.2), and apparent total clearance (Cl/F) was 558.8 mL/min (424.3-735.9). The median time to maximal concentration (tmax) was 4 hours, with a range of 1.5 to 4. Blood pressure, pulse rate, and ECG parameters did not change significantly from baseline. No serious adverse events or subject withdrawal after drug administration occurred. Oral naratriptan pharmacokinetic parameters in adolescents were similar to values reported in adults. Naratriptan doses for adolescents older than 12 years of age would be expected to be similar to adult doses. [ABSTRACT FROM AUTHOR]

Objective: The use of umbilical artery catheters (UACs) for parenteral nutrition (PN) administration is controversial, and limited data exist on the safety of administration through this route. The objective of this research is to evaluate neonates who received PN through a UAC and assess catheter-related complications and PN composition., Methods: This retrospective study evaluated all neonates who received PN through their UAC while admitted in the neonatal intensive care unit between January 2019 and December 2022. Neonates were evaluated for development of catheter-related complications such as infiltration, extravasation, thrombus formation, infection, or hypertension., Results: The administration of PN through UAC was identified in 31 neonates. Among the 31 neonates, 17 (55%) were classified as preterm, and 15 (48%) were classified as low birth weight. No patient experienced a UAC-related complication. Death occurred among 7 (23%) neonates. Two deaths occurred while the neonates were receiving PN via the UAC, but neither death was attributed to UAC complications. In 19 (61%) of the 31 neonates, osmolarity of PN exceeded 900 mOsm/L., Conclusions: Results of this study suggest that UACs may serve as a safe route for PN administration in neonates. The absence of catheter-related complications and the absence of adverse events support the safety of this approach. Further research with a larger sample size and rigorous study design is warranted to validate these findings and establish guidelines for the use of UACs in PN administration., Competing Interests: Disclosure. The authors declare no conflicts or financial interest in any product or service mentioned in the manuscript, including grants, equipment, medications, employment, gifts, and honoraria. The authors had full access to all the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis., (Copyright. Pediatric Pharmacy Association. All rights reserved. For permissions, email: membership@pediatricpharmacy.org.)

Objective: To evaluate age, adjunctive antiseizure medication (ASM), and specific ASMs on lacosamide (LCM) weight normalized dose-to-concentration ratio (DCR) and US Food and Drug Administration (FDA) dosing guidelines in pediatric patients., Methods: Patients 1 mo to ≤18 years with a LCM serum concentration between October 2009 and June 2017 were considered. Demographics, LCM DCR, and adjunctive ASM were recorded. LCM DCR/hr was used as a surrogate for clearance. Data were stratified by age (1 mo-< 2 yr; ≥ 2-6 yr; ≥ 6-12 yr; and ≥12-≤18 yr), FDA dosing weights, and ASM potential to interaction with LCM., Results: There were 646 sera (380 patients) with median dose 8.36 mg/kg/day (IQR, 5.92-11.16). 50.2% of doses were within FDA-weight guidelines; however, 40.4% exceeded recommendations. Most (81.3%) LCM concentrations were between 2 and 12 mg/L. A difference existed in DCR between ages, with those <2 years having the highest DCR (p < 0.001). Moving across age groups, the DCR decreases by 30.7%, 50.5%, and 63.4%. There was a weak (r 2 = 0.073) but significant (p < 0.001) negative correlation between DCR and age. 84.8% received adjunctive ASM consisting of at least one of 31 different ASMs. DCR was higher with adjunctive ASMs compared with monotherapy [0.061 (0.039-0.095) vs 0.043 (0.030-0.062)], respectively (p < 0.001) and was greatest with inducers. Phenobarbital increased DCR by 2.6-fold, topiramate by 72.1%, and clobazam by 32.6%. Inhibitors had no effect., Conclusions: The correlation between age and DCR was weak, accounting for 6% of variability. Strong inducers significantly increased DCR. Synergy may exist when multiple inducers are given. Weak inhibitors did not affect DCR. Those ≥6 to 11 kg, ≥30 to 50 kg, and those given strong inducers may require larger -initial LCM doses. Serum concentrations should be used to individualize dosing, especially in those receiving strong inducers., Competing Interests: Disclosures Drs Woods, Phelps, Christensen, and Meibohm declare no conflicts or financial interest in any product or service mentioned in the manuscript, including grants, equipment, medications, employment, gifts, and honoraria. Dr Wheless has received grant support from Lundbeck, Eisai, GlaxoSmithKline, King Pharmaceuticals, Supernus, The Shainberg Foundation, and the National Institutes of Health. He has served as a consultant to Lundbeck, Cyberonics, Pfizer, Eisai, and Sunovion and has received speaking fees from Lundbeck, Questcor, Cyberonics, and Eisai. Dr Woods, Phelps, and Christensen had full access to all the data and take responsibility for the integrity of the data and accuracy of the data analysis., (Copyright. Pediatric Pharmacy Association. All rights reserved. For permissions, email: membership@pediatricpharmacy.org.)

The Danish healthcare system is currently undergoing a transformation towards increased use of virtual healthcare services. In this review, we propose a structured risk-stratified model to delineate the differences between homecare, homemonitoring, and hospital-at-home, while discussing their current status and addressing barriers hindering the widespread adoption and scaling of home-based care incl. technological limitations, regulatory complexities, and cultural considerations. We advocate for establishing a national central support function to expedite the shift towards home-based care., (Published under Open Access CC-BY-NC-BD 4.0. https://creativecommons.org/licenses/by-nc-nd/4.0/.)

Introduction: Overweight and obesity constitute a major concern among patients treated at forensic psychiatric departments. The present clinical feasibility study aimed at investigating the extent to which glucagon-like peptide 1 receptor agonist (GLP-1RA) treatment with once-daily liraglutide 3.0 mg could be a feasible pharmacological treatment of these conditions in patients with schizophrenia spectrum disorders hospitalised in forensic psychiatry., Methods: The 26-week, open-label feasibility study included participants aged 18-65 years diagnosed with a severe mental illness and hospitalised at a forensic psychiatric department. At the time of inclusion, all participants fulfilled the indication for using liraglutide as a treatment for overweight and obesity. Participants' baseline examinations were followed by a 26-week treatment period with liraglutide injection once daily according to a fixed uptitration schedule of liraglutide, with a target dose of 3.0 mg. Each participant attended seven visits to evaluate the efficacy and adverse events. The primary endpoint was the number of "completers", with adherence defined as >80% injections obtained in the period, weeks 12-26. Determining whether liraglutide is a feasible treatment was pre-defined to a minimum of 75% completers., Results: Twenty-four participants were included in the study. Sex, male = 19 (79.2%). Mean age: 42.3 [25th and 75th percentiles: 39.1; 48.4] years; body mass index (BMI): 35.7 [31.7; 37.5] kg/m 2 ; glycated haemoglobin (HbA1c): 37 [35; 39] mmol/mol. Eleven out of 24 participants (46%) completed the study. For the completers, the median net body weight loss after 26 weeks of participation was -11.4 kg [-15.4; -5.9]. The net difference in HbA1C and BMI was -2.0 mmol/mol [-4; -1] and -3.6 kg/m 2 [-4.7; -1.8], respectively. The weight change and reduction in HbA1c and BMI were all statistically significant from baseline., Conclusion: The study did not confirm our hypothesis that liraglutide is a feasible treatment for a minimum of 75% of the patients initiating treatment with liraglutide while hospitalised in a forensic psychiatric department. The high dropout rate may be due to the non-naturalistic setting of the clinical trial. For the proportion of patients compliant with the medication, liraglutide 3.0 mg was an efficient treatment for overweight., (© 2024 The Authors. Acta Psychiatrica Scandinavica published by John Wiley & Sons Ltd.)

Dredging of lake sediment is a method to remove accumulated phosphorus and nitrogen in lakes and thereby reducing the risk of eutrophication. After dredging, the sediment is dewatered to reduce the volume. It is important to get a high dry matter content and ensure that the filtrate does not contain harmful compounds so it can be returned to the lake. A pilot-scale belt filter and flexible intermediate bulk containers (FIBC) were used for dewatering lake sediment with the sediment treated with a synthetic polymer or three different biopolymers. The goal of the study was to retain the phosphorus in the filter cake while returning the filtrate to the lake with a minimal phosphorus content. Results showed dry matter content of up to 16 % in the dewatered sediment and the sediment retained 96-99 % of the phosphorus. Furthermore, nitrogen was reduced by 27-71 % in the filtrate water. Toxicity tests found low ecotoxicity for most biopolymer filtrates, whereas synthetic polymer showed the highest potential ecotoxicity. Consequently, biopolymers provided satisfactory results, proving more environmentally friendly despite requiring longer filtration time., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Morten Christensen reports financial support was provided by Poul Due Jensen Foundation., (Copyright © 2023 Elsevier B.V. All rights reserved.)

Membrane fouling significantly reduces membrane permeability, leading to higher operational expenses. In situ monitoring of membrane fouling can potentially be used to reduce operation cost by optimizing operational parameters and cleaning conditions. In this study, a platinum wire with a diameter of 20 µm was attached to the surface of a ceramic ultrafiltration membrane, and by measuring the voltage across the wire while applying an AC current, the amplitude of the third harmonic wave, the so-called 3ω signal, was obtained. Results showed increasing 3ω signals during formation of fouling layers, which correlates directly to the hydraulic resistance of the formed fouling layer in semi-dead end filtration of polymeric core shell particles and crossflow filtration of diluted milk. This is explained by the insulating effect of the fouling layers which reduces heat convection by crossflow and the different thermal conductivity in the fouling layer compared with the feed. After membrane cleaning, the permeability and the magnitude of the 3ω signal were partly restored, showing that the 3ω method can be used to monitor the effect of cleaning. The frequency of the AC current was varied so it was possible to measure the heat conductivity in the fouling layer (high frequency) and heat convection due to cross-flow (low frequency). This may potentially be used to get information of the type of fouling (heat conductivity) and thickness of the fouling layer (AC frequency where heat conductivity becomes dominating)., (© 2023. Springer Nature Limited.)

In the frame of the global phosphorus (P) crisis and ongoing eutrophication issues in the environmental sector, lake sediment can be considered as an alternative P source after its removal from eutrophic lakes. However, high water contents make sediment dewatering a crucial step towards the efficient reusability of remaining solids. The application of polymeric substances facilitates solid-liquid separation by flocculation of suspended particles. To lower the environmental risk of contamination with toxic, non-biodegradable monomeric residues during and after the application of synthetic polyacrylamide(PAM)-based polymers, switching to natural polymeric substances (biopolymers), e.g., starch- or chitosan-based, is increasingly emphasized. The dewatering performance of four conventional PAM-based polymers was compared to two starch- and one chitosan-based biopolymer. Laboratory experiments were conducted to determine the dewatering rate, floc size and strength, and reject water quality. Biopolymers generally caused the formation of smaller but less shear-sensitive flocs, and lower P levels in the reject water compared to synthetic polymers. Dewatering performance was correlated to the most important functioning influencing polymer-specific properties intrinsic viscosity (polymer extension) and surface charge density (CD). Due to the high CD and low intrinsic viscosity of the biopolymers, electrostatic patch flocculation seems to be the favored flocculation mechanism, while for synthetic polymers bridging seems to be dominating. Solid-liquid separation technologies should be adjusted to the resulting floc size and structure, while surface CD and intrinsic viscosity are important properties for the choice of biopolymer. Overall, biopolymers can function as a more environmentally friendly alternative to synthetic products for lake sediment dewatering accompanied by the potential for P recovery., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Background: Racial/ethnic minorities are less likely than non-Hispanic White (White) patients to be included in the Medicare Part D Star Ratings measure assessment due to the restrictive inclusion criteria for the measures., Objective: This paper examined the effects of racial/ethnic disparities in the measure assessment in Part D Star Ratings on disparities in healthcare costs among patients with Alzheimer's disease and related dementias (ADRD)., Methods: This cross-sectional study analyzed 2017 Medicare data. Proportions of Beneficiaries with ADRD were categorized into the included and excluded groups based on the inclusion criteria for the calculation of medication adherence measures in Star Ratings. Outcomes included costs for medications, physician visits, emergency room (ER) visits, and total costs. A generalized linear model was employed to compare costs across racial/ethnic groups. To explore the differential disparities in healthcare costs between the 2 groups, interaction terms between dummy variables for being excluded from the measure calculation and racial/ethnic minorities were included in the models., Results: The patterns of racial/ethnic disparities in healthcare costs found in this study were generally consistent with expectations, with some exceptions. For example, compared with White patients, in the hyperlipidemia cohort, the physician visit cost for Black patients among the included group was 31% lower (cost ratio or CR = 0.69, 95% CI = 0.67-0.72); in the hypertension cohort, the hospitalization cost for Blacks among the excluded group was 15% higher (CR = 1.15, 95% CI = 1.12-1.19). More importantly, exclusion from measurement assessments was associated with differential cost disparities. For example, compared with individuals included in the measure assessment for hypertension, the Black-White disparities in costs for hospitalization and total healthcare were 30% higher (CR = 1.30, 95% CI = 1.26-1.34), and 10% higher (CR = 1.10; 95% CI = 1.08-1.12), respectively, among the excluded group., Conclusions: Medicare Part D Star Ratings may be associated with aggravated racial/ethnic disparities in healthcare costs in the Medicare Part D population., Competing Interests: Research reported in this publication was supported by the National Institute on Aging of the National Institutes of Health under Award Number R01AG049696. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. The authors list the following conflicts of interest: Chi Chun Steve Tsang: None; Yongbo Sim: None; Michael L. Christensen: None. Junling Wang: Received funding from AbbVie, Curo, Bristol Myers Squibb, Pfizer, and Pharmaceutical Research and Manufacturers of America (PhRMA), and serves on the Health Outcomes Research Advisor Committee of the PhRMA Foundation., (© 2023 The Authors.)

Organic compounds in wastewater are required for the biological removal of nitrogen, but they can also be used for biogas production. Distribution of the internal organic carbon at the plant is therefore critical to ensure high quality of the treated water, reduce greenhouse gas emissions, and optimize biogas production. We describe a wastewater treatment plant designed to focus equally on energy production, water quality, and reduced emissions of greenhouse gases. A disk filter was installed to remove as much carbon as possible during primary treatment. Primary sludge was then hydrolyzed and centrifuged. The hydrolysate centrate contained volatile fatty acids and was used either for the secondary wastewater treatment or to produce biogas. The yield during hydrolysis was 30-35 g volatile fatty acid per kg dry material or 40-65 g soluble COD per kg total solid. The specific denitrification rate was 20-40 g/(g·min), which is on the same order of magnitude as that for commonly used external carbon sources. Hydrolysis at around 35 °C and pH 7 gave the best results. The hydrolysate centrate can be stored and added to the biological treatment to improve water quality and reduce emissions of nitrous oxide or it can be used to produce biogas to optimize the operation of the plant., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 The Authors. Published by Elsevier B.V. All rights reserved.)

Phosphorus, a limited resource, is also an environmental pollutant that should be removed from wastewater and ideally reused. A pilot-scale facility was set up and used to precipitate and recover phosphorus from wastewater. The return activated sludge in a hydrolysis tank was flocculated and separated and the solid material returned to the hydrolysis tank; the flocculation process did not harm the microorganisms. Phosphate in the reject water was precipitated with different calcium salts and the phosphorus-containing precipitate recovered. The precipitate consisted mainly of phosphate and calcium, and under 5% of the final product consisted of iron and aluminum. Around 20% of the precipitate was organic material. The pilot-scale test was supplemented with bench-scale tests using calcium salt, magnesium salt, and NaOH/KOH. Without the addition of calcium ions, phosphate could be precipitated by increasing pH to 9.5, resulting in a concentration of phosphorus in the reject water of under 2 mg/L. If calcium salt was added (Ca:P ratio of 2:1), it was possible to remove phosphate at pH 9 (<1 mg/L). In general, the concentration of dissolved phosphate was 8-10 mg/L lower after precipitation when calcium salt was used compared with all other tested salts. This difference increased if additional phosphate was added to the sludge. The bench- and pilot-scale experiments yielded comparable data. At the pilot-scale facility, it was possible to remove 90% of the phosphate by adding calcium salt and regulating the pH to 8.5., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2021 The Authors. Published by Elsevier B.V. All rights reserved.)

Exploiting charge-transfer complexes in visible light-promoted single-electron redox reactions is a promising route for opening novel synthetic pathways, and catalytic approaches to complex formation are critical for facilitating this chemistry. This report describes the use of a substituted hydroquinone catalyst to promote radical perfluoroalkylation reactions. Mechanistic studies indicate that the reaction is initiated through formation of a visible light-absorbing halogen bonding complex between the hydroquinone catalyst and the perfluoroalkyl halide radical precursor.

This study examines how maternal education shapes the life and health of their children. Causal effects are identified from a Danish school reform that increased minimum compulsory schooling from 7 to 9 years in 1972 and estimates are based on large administrative registers. We find that the reform as well as maternal education when instrumented by it, has significant, positive effects on mothers' age at first birth and maternal health. Nevertheless, maternal education has no systematic causal effects on child health, neither at birth, during childhood, or in adolescence. This null finding is robust to a wide range of model specifications., Competing Interests: Declarations of Competing Interest None., (Copyright © 2021 The Author(s). Published by Elsevier B.V. All rights reserved.)

Nutrients were extracted from digester supernatant sampled from a full-scale enhanced biological phosphorus removal (EBPR) wastewater treatment plant. A four-compartment selectrodialysis setup was used to extract ammonium and phosphate in two separate compartments. The initial phosphate recovery rate was measured to be 0.072 mmol m -2  s -1 and the initial ammonium recovery rate was measured to be 1.31 mmol m -2  s -1 . The ammonium recovery rate was 18 times higher than that for phosphate, whereas the molar concentration of ammonium in the feed was 10 times higher than that of phosphate. An average recovery of 72 ± 1% and 90 ± 10% for ammonium and phosphate was observed after 3 h of operation. A monovalent anion selective (MVA) membrane was used to avoid ammonium and reduce the concentration of monovalent anions in the phosphorus stream. The pH in the phosphorus stream was kept at 10 so phosphate did not pass the MVA membrane. A membrane area of 26 m 2 per m 3 digester supernatant was required to recover 70% of phosphate and ammonium for the digester supernatant that contained 6 mM phosphate and 105 mM ammonium.

Membrane bioreactors (MBRs) for wastewater treatment show great potentials in the sustainable development of urban environments. However, fouling of membranes remains the largest challenge of MBR technology. Dissolved extracellular polymeric substances (EPS) are often assumed be the main foulant in MBRs. However, single bacterial cells are often erroneously measured as EPS in traditional spectrophotometric analysis of EPS in activated sludge, so we hypothesized that single cells in many cases could be the true foulants in MBRs for wastewater treatment. To study this, raw MBR sludge and sludge supernatant with varying concentrations of planktonic cells were filtered on microfiltration (MF) membranes, and we found a direct correlation between the cell count and rate of flux decline. Addition of planktonic cells to fresh MBR sludge dramatically increased the flux decline. The identity of the most abundant planktonic cells in a full-scale MBR water resource recovery facility was determined by DNA fingerprinting. Many of these genera are known to be abundant in influent wastewater suggesting that the influent bacterial cells may have a direct effect on the fouling propensity in MBR systems. This new knowledge may lead to new anti-fouling strategies targeting incoming planktonic bacteria from the wastewater feed. PRACTITIONER POINTS: Planktonic cells constituted up to 60% of the total protein content of "soluble extracellular polymeric substances" in membrane bioreactor sludge. Planktonic cells are hidden under a surrogate concentration of extracellular polymeric substances which is often associated with fouling. Membrane fouling rate is directly proportional to amount of free planktonic cells suspended in sludge. Several influent bacterial genera are enriched in the water phase of membrane bioreactor sludge. Removing these may mitigate fouling., (© 2020 Water Environment Federation.)

Objective: To determine if increased mortality could be detected with the administration of ceftriaxone and IV calcium in infants through an analysis of a large repository of electronic health records., Methods: Patients were split into 3 groups: 1) neonates, 2) infants, and 3) infants <1 year whose age was not specified. Deaths were classified into mutually exclusive categories based on the administration and timing of ceftriaxone and IV calcium. Crude death rates were calculated, and logistic regression modeling was used to calculate adjusted relative odds of death with associated covariates., Results: A total of 259,149 infants were identified. Of 79,038 neonates, the proportion of patients that received ceftriaxone and IV calcium within 48 hours who died was 3.8%, compared with 1.95% (IV calcium), 0.3% (ceftriaxone), 1.54% (IV fluids), and 2.03% (parenteral nutrition). For 102,456 infants, the proportions of deaths were 5.47% (ceftriaxone and IV calcium within 48 hours), 0.45% (IV calcium), 0.15% (ceftriaxone), 0.39% (IV fluids), and 5.5% (parenteral nutrition). Multivariate analysis showed increased odds of death in infants who received ceftriaxone and IV calcium within 48 hours, regardless of age, and propensity score-matched analysis showed a more than 2-fold increased risk for death., Conclusions: The increased risk for death following ceftriaxone and IV calcium administration was noted not only in neonates, but among older infants as well., Competing Interests: Disclosures. The authors declare no conflicts or financial interest related to the manuscript., (Copyright. Pediatric Pharmacy Association. All rights reserved. For permissions, email: mhelms@pediatricpharmacy.org 2021.)

Organocatalytic enantioselective 1,3-dipolar [6+4] cycloadditions of pyrylium ion intermediates with fulvenes promoted by a chiral primary amine catalyst have been developed to proceed in moderate to good yields and high enantioselectivities. The resultant chiral bicyclo[6.3.0]undecane scaffold containing a transannular bridging ether is densely functionalised providing a rigid scaffold for further manipulations. Computational studies give important insights into the role of the primary amine catalyst. Analysis of the reaction shows that the catalytic reaction proceeds in a step-wise manner and rationalises the stereochemical outcome of the reaction. Several stereoselective complexity-generating transformations, facilitated by the diverse functional groups and transannular bridge, are presented, highlighting the versatility of the core towards a number of the cyclooctanoid natural products., (© 2020 Wiley-VCH GmbH.)

Phosphorus recovery from wastewater is a focus area in Denmark; the aim is to recover at least 80% of the phosphorus. In order to extract phosphorus, surplus sludge from wastewater treatment plants was acidified (pH 2-4) to increase the dissolved phosphorus concentration, which then can be precipitated and recovered. Pilot-scale acidification and dewatering tests were done using sludge from three different wastewater treatment plants: plant (1) digested primary and secondary sludge, plant (2) digested primary sludge, and plant (3) non-digested sludge. Treatment of digested sludge gave the highest phosphorus release, but the acid consumption was high due to carbon dioxide stripping. The dry matter content of the acidified dewatered sludge was high (20-40%), but the dry matter content in the filtrate increased with decreasing pH. Approximately half of the dry matter content in the filtrate could be removed by introducing an additional separation step. The optimal pH for phosphorus extraction was 3, where up to 68% of the phosphorus was dissolved. Part of the released orthophosphate was lost with the filter cake but still, 60% of the total phosphorus content in the sludge ends up in the filtrate.

The anodizing industry generates several alkaline and acidic wastewater streams often with high concentrations of heavy metals. In this study, nanofiltration (NF) was used to treat wastewater from individual baths, i.e., wastewater from color rinse, alkaline pickling rinse, acidic pickling rinse and anodizing rinse, as well as a mixture of all the wastewater streams. The experiments were carried out by using a commercial membrane (NF99HF) exhibiting pure water permeability of 10 L/(m 2 ·h·bar). For all wastewater streams except one, pH was adjusted to bring it within the recommended pH limits of the membrane, whereby part of the heavy metals precipitated and was removed. The NF of the color rinse offered high-quality permeate (heavy metals below detection limit) and high permeability (9 L/(m 2 ·h·bar)), whereas the nanofiltration of the alkaline pickling rinse exhibited no permeability. The NF of the acidic pickling rinse showed a permeability of 3.1-4.1 L/(m 2 ·h·bar), but low ion rejection (7%-13%). NF of the neutralized mixed wastewater, after the removal of precipitate, produced high-quality permeate with a stable permeability of 1 L/(m 2 ·h·bar). Treatment of the mixed wastewater is therefore the best option if the water has to be discharged. If the water has to be reused, the permeate conductivity in the color rinse and anodizing rinse baths have been reduced significantly, so the treatment of these streams may then be a better option., Competing Interests: The authors declare no conflict of interest.

A methodology was developed for direct observation and analysis of particle movements near a microfiltration membrane. A high speed camera (1196 frames per second) was mounted on a microscope to record a hollow fiber membrane in a filtration cell with a transparent wall. Filtrations were conducted at varying pressure and crossflow velocities using synthetic core-shell particles (diameter 1.6 μm) of no and high negative surface charge. MATLAB scripts were developed to track the particle positions and calculate velocities of particle movements across and towards the membrane surface. Data showed that the velocity of particles along the membrane increases with distance from the membrane surface which correlates well with a fluid velocity profile obtained from CFD modelling. Particle track and trace was used to calculate the particle count profiles towards the membrane and document a higher concentration of particles near the membrane surface than in the bulk. Calculation of particle velocity towards and away from the membrane showed a region within 3-80 μm from the membrane surface with particle velocities higher than expected from the velocity of water through the membrane, thus the permeation drag underpredicts the actual velocity of particles towards the membrane. Near the membrane, particle velocities shift direction and move away. This is not described in classical filtration theory, but it has been speculated that this is an effect of particle rotation or due to membrane vibration or change in flow pattern close to the membrane.

We report an experimental discovery and computational investigation of the first photochemical stereoselective [1,3]-sigmatropic silyl shift of an allylsilane. An organocatalytic enantioselective cascade annulation generates a trimethylsilyl- o -isotoluene reactant in >99:1 e.r., and this trimethylsilyl- o -isotoluene contains an allylic silane moiety that undergoes a stereoselective photochemical [1,3]-silyl shift to form a benzylsilane with 96:4 e.r. The mechanism of this unprecedented [1,3]-silyl shift has been elucidated by a series of experimental studies and CASSCF, DFT, and TD-DFT calculations on model systems and the experimental system. The highly stereoselective photoreaction is proposed to occur via a singlet silyl/allyl conical intersection. This is a new demonstration of the role of conical intersections in selective photochemistry.

Carbohydrate is the macronutrient that has the greatest impact on blood glucose response. Limited data are available on how carbohydrate distribution throughout the day affects blood glucose in women with gestational diabetes mellitus (GDM). We aimed to assess how a high-carbohydrate morning-intake (HCM) versus a low-carbohydrate-morning-intake (LCM), affect glycemic variability and glucose control. In this randomized crossover study continuous glucose monitoring (CGM) was performed in 12 women with diet treated GDM (75 g, 2-h OGTT ≥ 8.5 mmol/L), who went through 2 × 3 days of HCM and LCM. A within-subject-analysis showed a significantly higher mean amplitude of glucose excursions (MAGE) (0.7 mmol/L, p = 0.004) and coefficient of variation (CV) (5.1%, p = 0.01) when comparing HCM with LCM, whereas a significantly lower mean glucose (MG) (-0.3 mmol/L, p = 0.002) and fasting blood glucose (FBG) were found (-0.4 mmol/L, p = 0.01) on the HCM diet compared to the LCM diet. In addition, insulin resistance, expressed as Homeostatic Model Assessment for Insulin Resistance (HOMA-IR), decreased significantly during HCM. Results indicate that a carbohydrate distribution of 50% in the morning favors lower blood glucose and improvement in insulin sensitivity in women with GDM, but in contrary gives a higher glycemic variability.

The mechanical dewatering of sludge is important in order to achieve a high dry matter content, thereby lowering the transportation cost and the energy consumption during incineration. Thermogravimetric analysis is sometimes used to estimate the maximum dry matter content obtainable from mechanical dewatering, by measuring the critical moisture point. In this paper, the critical moisture point of digested sludge was measured and compared with vapour sorption curves. The critical moisture point was determined for raw and conditioned sludge to be 3.4 kg of water per kg of dry matter, corresponding to 23% w/w dry matter. This value was lower than the dry matter content obtained from the mechanical dewatering process, indicating that the dry matter content can exceed the critical moisture point. Moisture vapour sorption was measured for raw, conditioned, and dewatered sludges. The Blahovec and Yanniotis sorption isotherm fitted the experimental data well. Between 10 and 12 g of water was adsorbed as a monolayer per 100 g of dry matter. The rest of the moisture content was explained by the non-ideal Raoult's law, by including the effect of dissolved ions. At water activities above 0.95, the moisture content was determined by capillary condensation and cake compressibility. The water activity was higher than 0.95  at the critical moisture point and the capillary pressure was estimated to be 4-6 bars. This pressure was responsible for cake compression during drying, while the relatively low dry matter content at the critical moisture point may be due to the low capillary pressure., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

Phosphate, which contains the essential element phosphorous (P), is a necessary fertilizer for agriculture, but the current phosphate deposits are running out and alternative sources are needed. Sludge obtained from wastewater treatment plants contains high concentrations of phosphorus and represents an alternative, sustainable source. In this study, sludge obtained from a wastewater treatment plant with biological and chemical phosphorus removal was acidified (pH = 3, 4, 5 and 6) to release orthophosphate followed by sequestration of the orthophosphate by a zinc aluminum layered double hydroxide (Zn 2 Al-LDH). Sulfuric acid (H 2 SO 4 ), nitric acid (HNO 3 ), and hydrochloric acid (HCl) was tested, which showed that only sulfate anions compete with phosphate and results in reduced phosphate recovery (25-35%). The orthophosphate concentration in the liquid phase increased from 20% (raw sludge) to 75% of the total phosphorus concentration at a pH of 3, which enhanced the phosphate uptake by the ZnAl-LDH from 1.7 ± 0.2% to 60.3 ± 0.6%. During acidification, the competing anion carbonate is degassed as CO 2 , which further improved the phosphate uptake. PXRD showed the intercalation of carbonate in the LDH in the raw sludge at pH = 8, whereas orthophosphate was intercalated at lower pH values. 27 Al MAS NMR spectroscopy and powder X-ray diffraction (PXRD) proved preservation of the LDH at all pH values. Furthermore, about a fourth of the Al is present as an amorphous aluminum phosphate (AlPO 4 ) upon exposure to phosphate at low pH (pH = 3 and 5) based on 27 Al MAS NMR spectroscopy. At a pH of 6 about a third of the P is present as brushite (CaHPO 4 ·2H 2 O)., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

A direct and mild strategy for the synthesis of benzo[a]azulenes based on an organocatalytic [10+4] cycloaddition reaction is described. The strategy enables a diversity-oriented approach for the synthesis of various poly-functionalised azulenes from easily accessible starting materials.

Acidification was used to dissolve phosphorus from digested and non-digested sludge from five wastewater treatment plants in order to make phosphorus accessible for subsequent recovery. More phosphorus was dissolved from digested sludge (up to 80%), with respect to non-digested sludge (∼25%) and the highest release was observed at pH 2. The acid consumption for digested sludge was higher than for non-digested sludge due to the presence of the bicarbonate buffer system, thus CO 2 stripping increased the acid consumption. In all the experiments, the sludge was exposed to acid for 1 h. For the five tested sludge types, 60-100 mmol o-P was released per added mol H 2 SO 4 . It was mainly iron and calcium compounds that accounts for the phosphorus release at low pH. The release of heavy metals was in general low (<30%) for all the wastewater treatment plant, as Zn, Cd and Ni showed the most critical release after acidification of non-digested sludge., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

The first peri- and stereoselective [10+4] cycloaddition between catalytically generated amino isobenzofulvenes and electron-deficient dienes is described. The highly stereoselective catalytic [10+4] cycloaddition exhibits a broad scope with high yields, reflecting a robust higher-order cycloaddition. Experimental and computational investigations support a kinetic distribution of intermediate rotamers dictating the enantioselectivity, which relies heavily on additive effects., (© 2018 Wiley-VCH Verlag GmbH & Co. KGaA, Weinheim.)

The immense amount of electronic health data (pharmacy and administrative claims, electronic health records, and clinical registries) that is being generated every day in the care of patients has the potential to be leveraged for improving clinical decisions at the point of care, uncovering or validating drug efficacy and drug safety. The potential use of big data for improving safe and effective use of medications is especially important in children because of their low drug exposure relative to adults. Electronic health data is collected primarily for clinical or billing purposes and not for research purposes. The major steps involved in data acquisition, extraction, aggregation, analysis, modeling, and interpretation are discussed. It is important to understand the limitation of big data and utilize appropriate study design and statistical methods. Possible applications are presented along with specific examples of how big data has been used in drug research to find that blip on the radar screen that may give an efficacy or safety signal that can lead to further investigation., (© 2018, The American College of Clinical Pharmacology.)

The technical performance of a precoat filter was compared with that of a traditional sand filter. Particle concentration and size distribution were measured before and after the filtration of swimming pool water. Both the sand and precoat filters could reduce the particle concentration in the effluent. However, higher particle removal efficiency was generally observed for the precoat filter, especially for particles smaller than 10 μm in diameter. Adding flocculant improved the removal efficiency of the sand filter, resulting in removal efficiencies comparable to those of the precoat filter. Three powders, i.e., two types of perlite (Harbolite ® and Aquatec perlite) and cellulose fibers (Arbocel ® ), were tested for the precoat filter, but no significant difference in particle removal efficiency was observed among them. The maximum efficiency was reached within 30-40 min of filtration. The energy required for the pumps increased by approximately 35% over a period of 14 days. The energy consumption could be reduced by replacing the powder on the filter cloth. The sand filter was backwashed once a week, while the powder on the precoat filter was replaced every two weeks. Under these conditions, it was possible to reduce the water used for cleaning by 88% if the precoat filter was used instead of the sand filter.

The [8+2] cycloaddition of indene-2-carbaldehydes and nitro olefins is described to provide benzonorbornene scaffolds in a highly peri-, diastereo-, and enantioselective fashion in the presence of a C 2 -symmetric aminocatalyst. This reaction, which proceeds through a transient semi-aromatic amino isobenzofulvene, represents the first example of catalytic formation and transformation of these species. Quantum chemical calculations suggest a kinetically controlled stepwise mechanism where the stereochemistry is determined in the first bond-forming event. Beyond the useful [8+2] cycloadducts, [10+4] cycloadducts have been identified in silico as potential off-pathway intermediates., (© 2018 Wiley-VCH Verlag GmbH & Co. KGaA, Weinheim.)

Background: Lipid injectable emulsion (ILE) is an integral part of parenteral nutrition (PN), providing energy and essential fatty acids. With recent consensus recommendations for PN, clinical guidelines for ordering and preparation of PN, the U.S. Food and Drug Administration approval of new ILE products, and revised ILE labeling to include a 1.2-micron filter, a gap in current practice knowledge was apparent., Materials and Methods: The American Society for Parenteral and Enteral Nutrition PN Safety Committee surveyed clinicians on how ILE products are prescribed, prepared, and administered to patients from neonates to adults., Results: The results of this survey conducted in late 2016 found a wide variation in practice, particularly across patient age groups., Conclusion: These findings demonstrate the need for ongoing dissemination and education on standardized safe practices for ILE use.

A range of parameters affecting floc characteristics, sludge composition and filtration properties was investigated by analyzing 29 sludge samples from municipal and industrial conventional activated sludge systems and municipal membrane bioreactors (MBR). Samples were characterized by physico-chemical parameters, composition of ions and EPS, degree of flocculation, settling properties, dewatering properties, and filtration properties. By analyzing the interplay between various metrics instead of single parameters, a unified understanding of the influence of sludge composition and characteristics was developed. From this, a conceptual model was proposed to describe the interplay between sludge composition, characteristics, and filtration properties. The article shows three major results contributing to describe the interplay between sludge characteristics and fouling propensity: First, the degree of flocculation could be quantified by the ratio between floc size and residual turbidity and was a key parameter to assess fouling propensity. Second, extracted EPS to polyvalent cations ratio was used as an indicator of the flocculation. A high ratio combined with a high concentration of EPS resulted in large, loosely bound, and weak flocs that were easily deformed, hence giving compressible fouling layers. Finally, high amounts of carbohydrates in both total and extracted EPS resulted in more pronounced fouling, which may be explained by carbohydrates forming poorer flocs than humic substances and proteins. Accordingly, samples with high humic content showed lower specific resistance to filtration due to better floc structure. The amount of carbohydrates in EPS correlated positively to the influent COD/N ratio, which may explain why systems with high influent COD/N ratio demonstrated higher fouling propensity., (Copyright © 2017 Elsevier Ltd. All rights reserved.)

A filtration devise was developed to assess compressibility of fouling layers in membrane bioreactors. The system consists of a flat sheet membrane with air scouring operated at constant transmembrane pressure to assess the influence of pressure on resistance of fouling layers. By fitting a mathematical model, three model parameters were obtained; a back transport parameter describing the kinetics of fouling layer formation, a specific fouling layer resistance, and a compressibility parameter. This stands out from other on-site filterability tests as model parameters to simulate filtration performance are obtained together with a characterization of compressibility. Tests on membrane bioreactor sludge showed high reproducibility. The methodology's ability to assess compressibility was tested by filtrations of sludges from membrane bioreactors and conventional activated sludge wastewater treatment plants from three different sites. These proved that membrane bioreactor sludge showed higher compressibility than conventional activated sludge. In addition, detailed information on the underlying mechanisms of the difference in fouling propensity were obtained, as conventional activated sludge showed slower fouling formation, lower specific resistance and lower compressibility of fouling layers, which is explained by a higher degree of flocculation.

Objective: To compare the effectiveness of arteriovenous anastomosis (AVA) vs heated intravenous fluid (IVF) rewarming in hypothermic subjects. Additionally, we sought to develop a novel method of hypothermia induction., Methods: Eight subjects underwent 3 cooling trials each to a core temperature of 34.8±0.6 (32.7 to 36.3°C [mean±SD with range]) by 14°C water immersion for 30 minutes, followed by walking on a treadmill for 5 minutes. Core temperatures (Δtes) and rates of cooling (°C/h) were measured. Participants were then rewarmed by 1) control: shivering only in a sleeping bag; 2) IVF: shivering in sleeping bag and infusion of 2 L normal saline warmed to 42°C at 77 mL/min; and 3) AVA: shivering in sleeping bag and circulation of 45°C warmed fluid through neoprene pads affixed to the palms and soles of the feet., Results: Cold water immersion resulted in a decrease of 0.5±0.5°C Δtes and 1±0.3°C with exercise (P < .01); with an immersion cooling rate of 0.9±0.8°C/h vs 12.6±3.2°C/h with exercise (P < .001). Temperature nadir reached 35.0±0.5°C. There were no significant differences in rewarming rates between the 3 conditions (shivering: 1.3±0.7°C/h, R 2 = 0.683; IVF 1.3±0.7°C/h, R 2 = 0.863; and AVA 1.4±0.6°C/h, R 2 = 0.853; P = .58). Shivering inhibition was greater with AVA but was not significantly different (P = .07)., Conclusions: This study developed a novel and efficient model of hypothermia induction through exercise-induced convective afterdrop. Although there was not a clear benefit in either of the 2 active rewarming methods, AVA rewarming showed a nonsignificant trend toward greater shivering inhibition, which may be optimized by an improved interface., (Copyright © 2017 Wilderness Medical Society. Published by Elsevier Inc. All rights reserved.)

Conventional resources of phosphorous are at high risk of depletion in the near future due to current practices of its exploitation, thus new and improved exploration methodologies need to be developed to ensure phosphorous security. Today, some treatment plants recover phosphorous from municipal wastewater as struvite (MgNH₄PO₄·6H₂O). Magnesium is often added to the wastewater as MgCl₂·6H₂O to facilitate the phosphorous recovery. However, the use of magnesium increases the costs of the process and is not aligned with sustainable development, therefore, alternative magnesium sources have to be found. The current study analyzes the feasibility of integrated membrane processes for magnesium recovery from seawater for utilization in the phosphorous recovery process. The integrated membrane systems consist of nanofiltration (NF), membrane distillation (MD), and membrane crystallization (MCr). The lowest associated cost is found for standalone NF treatment. However, the additional treatment with MD and MCr produces fresh water and salts like NaCl or potentially other valuable minerals at the expense of low-grade heat., Competing Interests: The authors declare no conflict of interest and the founding sponsors had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, and in the decision to publish the results.

As seen over the past 20 years, calprotectin has evolved as a novel, non-invasive biomarker of gastrointestinal (GI) inflammation. We present this review of calprotectin in pediatrics. This article will focus on studies using calprotectin concentrations from different body fluids to monitor inflammation in different disease states and conditions. The ultimate goal of our group is to lay down a foundation as we consider using calprotectin prospectively as a marker of intestinal inflammation that could lead to further testing and possibly a marker of preparedness for feeding. We surveyed all published studies in English of calprotectin in neonates, infants, children, and adolescents through February 2014. We will discuss calprotectin's basic properties and analysis such as characteristics, identification, presence in body fluids, and maturational development. In addition, calprotectin's use in inflammatory diseases exploring both GI and non-GI conditions will be evaluated and compared with other serum markers presently available. Finally, a summary of our findings and discussion of future work that could be undertaken in order to render calprotectin as a more useful monitoring tool to the medical research community will complete the review.

Membrane retention of the humic-like substances present in a soluble microbial products (SMP) suspension was studied by using a dead-end filtration system. The SMP suspension was extracted from the sludge of an enhanced biological phosphorus removal-membrane bioreactor. Our results showed that both adsorption and steric retention of the humic-like substances governed their transport through the membrane during the filtration. The adsorption, which followed pseudo-first order kinetics, did not cause substantial decline of permeate flux. The steric retention, on the other hand, formed a gel layer, which in turn led to a major decrease in the flux. The reduction of permeate flux was well predicted by cake filtration theory. Based on the adsorption and the steric retention, a new model was developed for predicting the overall membrane retention of the humic-like substances. The general trend of the modelled overall retention was in partial agreement with the experimental results.

Membrane permeability and salt rejection of a γ-alumina nanofiltration membrane were studied and modeled for different salt solutions. Salt rejection was predicted by using the Donnan-steric pore model, in which the extended Nernst-Planck equation was applied to predict ion transport through the pores. The solvent flux was modeled by using the Hagen-Poiseuille equation by introducing electroviscosity instead of bulk viscosity. γ-Alumina particles were used for ζ-potential measurements. The ζ-potential measurements show that monovalent ions did not adsorb on the γ-alumina surface, whereas divalent ions were highly adsorbed. Thus, for divalent ions, the model was modified, owing to pore shrinkage caused by ion adsorption. The ζ-potential lowered the membrane permeability, especially for membranes with a pore radius lower than 3 nm, a ζ-potential higher than 20 mV, and an ionic strength lower than 0.01 m. The rejection model showed that, for a pore radius lower than 3 nm and for solutions with ionic strengths lower than 0.01 m, there is an optimum ζ-potential for rejection, because of the concurrent effects of electromigration and convection. Hence, the model can be used as a prediction tool to optimize membrane perm-selectivity by designing a specific pore size and surface charge for application at specific ionic strengths and pH levels., (© 2015 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.)