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Removing antibiotics from water is critical to prevent the emergence and spread of antibiotic resistance, protect ecosystems, and maintain the effectiveness of these vital medications. The combination of ozone and electrocoagulation in wastewater treatment provides enhanced removal of contaminants, improved disinfection efficiency, and increased overall treatment effectiveness. In this work, the removal of sulfamethoxazole (SMX) from an aqueous solution using an ozone–electrocoagulation (O–EC) system was optimized and modeled. The experiments were designed according to the central composite design. The parameters, including current density, reaction time, pH, and ozone dose affecting the SMX removal efficiency of the OEC system, were optimized using a response surface methodology. The results show that the removal process was accurately predicted by the quadric model. The numerical optimization results show that the optimum conditions were a current density of 33.2 A/m2, a time of 37.8 min, pH of 8.4, and an ozone dose of 0.7 g/h. Under these conditions, the removal efficiency reached 99.65%. A three-layer artificial neural network (ANN) with logsig-purelin transfer functions was used to model the removal process. The data predicted by the ANN model matched well to the experimental data. The calculation of the relative importance showed that pH was the most influential factor, followed by current density, ozone dose, and time. The kinetics of the SMX removal process followed the first-order kinetic model with a rate constant of 0.12 (min−1). The removal mechanism involves various processes such as oxidation and reduction on the surface of electrodes, the reaction between ozone and ferrous ions, degradation of SMX molecules, formation of flocs, and adsorption of species on the flocs. The results obtained in this work indicate that the O–EC system is a potential approach for the removal of antibiotics from water.

Drug-induced liver injury (DILI) is a rare side effect of angiotensin-converting enzyme inhibitors (ACEIs). Ramipril is a widely used ACE compound because of its effectiveness in the treatment of hypertension and heart failure, as well as its low risk of adverse effects. However, the clinical features of ramipril, and the risk of DILI, have not been adequately studied. A retrospective cohort study was performed based on data from 3909 inpatients to compare the risk of DILI conferred by ramipril and other ACEIs. A logistic regression model was then constructed and validated against data from 1686 patients using ramipril, of which 117 patients were diagnosed with DILI. The use of ramipril increased the risk of DILI by 2.68 times (odds ratio = 2.68; 95% confident interval (CI):1.96-3.71) compared with the group using other ACEIs. The clinical features of DILI in the ramipril group were similar to those from the ACEI group (P>0.05), except that the ALT level was higher (P

The impact of direct-acting antivirals (DAA) therapy on lipid and glucose metabolism and kidney function in patients with hepatitis C virus (HCV) infection, along with its side effects on blood cells, remains controversial. Therefore, we conducted a study that enrolled 280 patients with HCV infection who achieved sustained virologic response after treatment with DAA therapy without ribavirin to evaluate the metabolic changes, renal function, and anemia risk based on real-world data. This study was an observational prospective study with a follow-up period of 12 weeks after the initiation of DAA therapy. Data on biochemical tests, renal function, blood counts, viral load, and host genomics were recorded before treatment and after 12 weeks of treatment with DAAs. DAA therapy reduced fibrosis-4 scores and improved liver function, with significant reductions in aspartate transaminase, alanine aminotransferase, and total bilirubin levels. However, DAA therapy slightly increased uric acid, cholesterol, and low-density lipoprotein cholesterol levels. It significantly reduced fasting blood glucose levels and hemoglobin A1C index (HbA1C) in the study group, while hemoglobin (Hb) and hematocrit (HCT) concentrations decreased significantly (4.78 ± 21.79 g/L and 0.09% ± 0.11%, respectively). The estimated glomerular filtration rate (eGFR) decreased by 12.89 ± 39.04 mL/min/1.73m2. Most variations were not related to the genotype, except for Hb, HCT, and HbA1C. Anemia incidence increased from 23.58% before treatment to 30.72% after treatment. Patients with HCV-1 genotype had a higher rate of anemia than did patients with genotype 6 (36.23% vs. 24.62%). Multivariate analysis showed that the risk of anemia was related to female sex, cirrhosis status, fibrosis-4 score, pretreatment eGFR, and pretreatment Hb level. The results of our study can provide helpful information to clinicians for the prognosis and treatment of HCV infection.