Magnetic MgFe2O4-CaFe2O4 S-scheme photocatalyst prepared from recycling of electric arc furnace dust

In this research, magnetic MgFe₂O₄-CaFe₂O₄ photocatalyst powder was prepared from recycling of electric arc furnace (EAF) dust as a secondary source through a two-step leaching process followed by co-precipitation method. To maximize the total Fe to Ca recovery ratio (F/C) and evaluate the effective parameters of sulfuric acid concentration and temperature, response surface methodology (RSM) as a design of experiment was used. The best temperature and acid concentration were obtained as 85 °C and 1 M, respectively for the second step of the leaching process. X-ray diffraction (XRD) results indicated that the synthesized nanocomposite sample contains MgFe₂O₄ and CaFe₂O₄ phases together with a small amount of Ca₂Fe₂O₅. The saturation magnetization and optical band gap of the synthesized composite powder were 24 emu/g and 2.17 eV, respectively. X-Ray photoelectron spectroscopy (XPS) result revealed the oxidation states as Fe³⁺, Ca²⁺, Mg²⁺ and O^2-. Energy dispersive X-ray spectroscopy (EDS) showed that the elements were uniformly distributed within the nanostructured particles. Field emission scanning electron microscope (FESEM) and transmission electron microscope (TEM) results indicated the presence of CaFe₂O₄ and MgFe₂O₄ nanoparticles with good contact between them. The nanocomposite sample showed the capability of 45% for degrading methylene blue (MB) dye under 240 min visible light irradiation. The reusability tests showed that the photocatalytic activity of the nanocomposite was not considerably changed after three cycles.

Extrapulmonary manifestations of severe acute respiratory syndrome coronavirus-2 infection

Coronavirus disease 2019, the infectious disease caused by severe acute respiratory syndrome coronavirus-2, has resulted in a global pandemic with unprecedented health, societal, and economic impact. The disease often manifests with flu-like symptoms and is dominated by pulmonary complications, but widely diverse clinical manifestations involving multiple organ systems can result. We posit that viral tropism and the aberrant host immune response mediate the protean findings and severity in this disease. In general, extrapulmonary manifestations are a harbinger of or contemporaneously associate with disease progression, but in the case of some extrapulmonary findings (gastrointestinal and dermatologic), may track with milder disease. The precise underlying pathophysiological mechanisms remain incompletely elucidated, and additional immune phenotyping studies are warranted to reveal early correlates of disease outcomes and novel therapeutic targets.

Preventive Health Care Among Postpartum Women With Inflammatory Bowel Disease: Results From the PIANO Registry

BACKGROUND

Health care maintenance (HCM) is reduced among inflammatory bowel disease (IBD) patients. This study aims to characterize rates of HCM in a closely monitored subpopulation-postpartum women with IBD-and identify predictors of noncompliance.

METHODS

A national prospective pregnancy registry was utilized to collect completion rates of HCM recommendations (cervical cancer screening; osteoporosis screening; pneumococcal, hepatitis A, hepatitis B, and influenza vaccines). Completion of a recommendation at least once during follow-up was sufficient, except for influenza vaccine, which was assessed yearly. Patients were classified by drug exposures: immunomodulator (Group A), biologic (Group B), combination therapy (Group AB), and unexposed. Confounders assessed were steroid exposure, IBD flare, IBD care site, primary care provider (PCP) access, marital status, income, education level, and race.

RESULTS

There were 628 postpartum IBD women with at least 1 year of follow-up. HCM rates were as follows: cervical cancer screening (84%), osteoporosis screening (54%), pneumococcal (50%), hepatitis A (61%), hepatitis B (81%), and influenza (72%) vaccines. The unexposed group demonstrated lower pneumococcal vaccination rates than groups A, B, and AB. Group B demonstrated lower cervical cancer screening rates than the unexposed. PCP access and low education predicted hepatitis vaccine noncompliance. Unmarried status and low income predicted cervical cancer screening noncompliance. Low income predicted influenza vaccine noncompliance.

CONCLUSIONS

Postpartum women have multiple providers, yet they complete HCM at suboptimal rates. Risk factors include biologic exposure, unmarried status, low income, low education, and access to a PCP. Awareness among providers and patients is important and needs to be enhanced.

Metabolic and molecular responses to calcium soap of fish oil fed to ewes during peripartal period

It has been shown that n-3 long chain fatty acids (n-3 LCFA) are involved in energy/lipid metabolisms, reproductive parameters, and molecular regulations leading to maintained homeostasis. We hypothesized that supplementation of peripartal diets with fish oil (FO), as a source of n-3 LCFA, could improve energy balance and modulate metabolic pressure in a sheep model. Prepartum ewes (n = 24) were fed control (CON) or calcium soap of fish oil (FO) supplemented-diet from four weeks before until three weeks after parturation. Feed intake, body weight (BW) change, plasma metabolites, colostrums/milk composition, and fatty acids profile of milk along with the expression of core microRNAs in glucose and lipid metabolism were evaluated. Prepartal feed intake decreased in FO group (1674 ± 33.26 vs. 1812 ± 35.56) though post-partal intake was similar. Differences in BW were not also significant (55.47 ± 2.07 in CON vs. 53.69 ± 1.94 in FO). No differences were observed in plasma metabolites except for cholesterol that was lower in FO group (56.25 ± 0.71 vs. 53.09 ± 0.61). Milk fat percentage was reduced (8.82 ± 0.49 vs. 7.03 ± 0.45) while the percentage of milk total n-3 LCFA increased in FO group. In accordance, the relative transcript abundance of miR-101 (0.215 ± 0.08) and miR-103 (0.37 ± 0.15) decreased by FO supplementation. Results showed that FO supplementation during peripartal period decreased milk fat, feed intake, plasma cholesterol, milk n-6:n-3 ratio and the expression of miR-101. Although the trend indicated that FO could alter lipid metabolism during transition period, further studies are needed to fully address its effect on energy balance and homeorhetic processes.

Randomized trial of 1-week versus 2-week intervals for endoscopic ligation in the treatment of patients with esophageal variceal bleeding

The appropriate interval between ligation sessions for treatment of esophageal variceal bleeding is uncertain. The optimal interval would provide variceal eradication as rapidly as possible to lessen early rebleeding while minimizing ligation-induced adverse events. We randomly assigned patients hospitalized with acute esophageal variceal bleeding who had successful ligation at presentation to repeat ligation at 1-week or 2-week intervals. Beta-blocker therapy was also prescribed. Ligation was performed at the assigned interval until varices were eradicated and then at 3 and 9 months after eradication. The primary endpoint was the proportion of patients with variceal eradication at 4 weeks. Four-week variceal eradication occurred more often in the 1-week than in the 2-week group: 37/45 (82%) versus 23/45 (51%); difference = 31%, 95% confidence interval 12%-48%. Eradication occurred more rapidly in the 1-week group (18.1 versus 30.8 days, difference = -12.7 days, 95% confidence interval -20.0 to -5.4 days). The mean number of endoscopies to achieve eradication or to the last endoscopy in those not achieving eradication was comparable in the 1-week and 2-week groups (2.3 versus 2.1), with the mean number of postponed ligation sessions 0.3 versus 0.1 (difference = 0.2, 95% confidence interval -0.02 to 0.4). Rebleeding at 4 weeks (4% versus 4%) and 8 weeks (11% versus 9%), dysphagia/odynophagia/chest pain (9% versus 2%), strictures (0% versus 0%), and mortality (7% versus 7%) were similar with 1-week and 2-week intervals.

CONCLUSION

One-week ligation intervals led to more rapid eradication than 2-week intervals without an increase in complications or number of endoscopies and without a reduction in rebleeding or other clinical outcomes; the decision regarding ligation intervals may be individualized based on patient and physician preferences and local logistics and resources. (Hepatology 2016;64:549-555).

The Effect of Maternal Peripartum Anti-TNFα Use on Infant Immune Response

BACKGROUND

Infliximab (IFX) and adalimumab (ADA) cross the placenta in the third trimester and can be detectable in infants for up to 12 months.

AIM

The aim of this study was to determine whether in utero IFX or ADA exposure results in an impaired immune response in infants, as measured by immunoglobulin levels and antibody responses to routine primary immunizations.

METHODS

Infants who were exposed to in utero anti-TNFα agents were prospectively evaluated. Immunoglobulin levels (IgG, IgM, IgA) and antibodies to standard vaccinations, including tetanus toxoid (tetanus) and Haemophilus influenza type b (Hib), were measured in infants of at least 6 months of age.

RESULTS

Twelve infants were prospectively studied: 10 exposed to in utero IFX and 2 exposed to ADA with at least one dose administered in the third trimester. Immunoglobulin levels were available on 10/12 patients, with all showing adequate immunoglobulin levels, except for low IgM levels in 5 (50 %) infants. Adequate responses to both the tetanus and Hib vaccines were seen in 11 of 12 (92 %) infants.

CONCLUSIONS

Infants exposed to anti-TNFα agents in utero demonstrate appropriate response to two commonly administered neonatal vaccines and show adequate immunoglobulin levels, except for IgM. Newborns with a history of exposure to anti-TNFα agents should follow a standard vaccination schedule for inactive vaccines.

Natural history of acute upper GI bleeding due to tumours: short-term success and long-term recurrence with or without endoscopic therapy

BACKGROUND

Scant information is available regarding patients with upper gastrointestinal bleeding (UGIB) from tumours.

AIM

To determine the presentation, endoscopic findings, treatment and outcomes in patients with UGIB from malignant tumours and identify risk factors associated with rebleeding.

METHODS

Consecutive patients who were hospitalised with haematemesis, melena or haematochezia and underwent upper endoscopy were identified retrospectively by reviewing an endoscopy database. Patients with UGIB due to biopsy-proven malignant tumours were studied.

RESULTS

Tumours were the source of bleeding in 106 (5%) of 2,166 patients with UGIB. Tumours were oesophageal in 17 (16%), gastric in 77 (73%) and duodenal in 12 (11%). At presentation, 84 (79%) did not have known cancer previously, and 79 (75%) had metastatic disease. Seventy-seven (73%) received transfusions at index hospitalisation. At endoscopy, 32 (30%) had active bleeding (31 oozing, 1 spurting). Among actively bleeding patients, haemostasis was achieved in 12 (86%) of 14 receiving endoscopic therapy and all 18 not receiving endoscopic treatment. Hospitalisation for rebleeding occurred in 50 (49%) of 103 at a median of 30 days (3-885). On multivariate analysis, age ≤60 years (OR = 2.49, 95% CI 1.06-5.81) and haemodynamic instability (OR = 2.42, 95% CI 1.08-5.46) were associated with rebleeding.

CONCLUSIONS

Patients presenting with tumour-associated UGIB have substantial blood loss, with three-quarters requiring transfusion at presentation. Initial haemostasis occurs in almost all patients, with or without endoscopic therapy, but rebleeding requiring repeat hospitalisation occurs in approximately half the patients and is more common in patients who are ≤60 years of age and have haemodynamic instability at presentation.

Optimization of petroleum refinery effluent treatment in a UASB reactor using response surface methodology

An upflow anaerobic sludge blanket (UASB) bioreactor was successfully used for the treatment of petroleum refinery effluent. Before optimization, chemical oxygen demand (COD) removal was 81% at a constant organic loading rate (OLR) of 0.4 kg/m(3) d and a hydraulic retention time (HRT) of 48 h. The rate of biogas production was 559 mL/h at an HRT of 40 h and an influent COD of 1000 mg/L. Response surface methodology (RSM) was applied to predict the behaviors of influent COD, upflow velocity (V(up)) and HRT in the bioreactor. RSM showed that the best models for COD removal and biogas production rate were the reduced quadratic and cubic models, respectively. The optimum region, identified based on two critical responses, was an influent COD of 630 mg/L, a V(up) of 0.27 m/h, and an HRT of 21.4 h. This resulted in a 76.3% COD removal efficiency and a 0.25 L biogas/L feed d biogas production rate.

Long-term impact of capsule endoscopy in patients referred for iron-deficiency anemia

BACKGROUND

Video capsule endoscopy (VCE) is recommended as the third diagnostic test for patients with iron-deficiency anemia (IDA) after a normal upper endoscopy and colonoscopy.

AIMS

To study long-term outcomes after VCE in patients with IDA.

METHODS

We performed a retrospective study of VCE studies performed at Stanford University Hospital or the VA Palo Alto Health Care System from 2002 to 2006. We assessed endoscopic or radiographic procedures performed post-CE and contacted patients by telephone in order to determine current medical status and potential resolution of anemia since the VCE.

RESULTS

We invited 153 patients to participate, and 82 (54%) patients agreed to enroll including 57 patients with IDA and 25 patients with overt gastrointestinal bleeding. The overt group received more transfusions pre-CE (P < 0.05). The mean follow-up time was 36 +/- 16 months (median 33 months, range 14-67) in the IDA referral group and 40 +/- 16 months (median 39 months, range 17-69) in the overt bleeding group (P = 0.3). Positive findings on VCE were detected in 35 (60%) and 15 (60%) patients in the IDA referral and overt groups, respectively (P= 1.0). Of the 35 patients in the IDA referral group with significant VCE findings, 15 underwent therapeutic procedures, while 20 were managed conservatively. Over the mean follow-up period, 23% of the IDA referral group and 22% of the overt group remained anemic (P = 0.30).

CONCLUSIONS

Most patients referred for VCE examination to evaluate IDA were no longer anemic at 36 months of follow-up, with or without therapeutic intervention.

Chemical colitis

Chemical colitis can occur as a result of accidental contamination of endoscopes or by intentional or accidental administration of enemas containing various chemicals. Most cases have occurred after accidental contamination of endoscopes with glutaraldehyde and/or hydrogen peroxide. There have been multiple case reports of chemical colitis resulting from unintentional administration of caustic chemicals. Intentional administration of corrosive enemas has been implicated in sexual practices, bowel cleansing, or in suicide attempts. Patients present with nonspecific symptoms including abdominal pain, rectal bleeding, and/or diarrhea. As chemical colitis remains rare, the literature consists of scattered case reports and small series. Agents implicated in chemical colitis that are covered in this review include alcohol, radiocontrast agents, glutaraldehyde, formalin, ergotamine, hydrofluoric acid, sulfuric acid, acetic acid, ammonia, soap, sodium hydroxide, hydrogen peroxide, herbal medicines, chloro-m-xylenol, and potassium permanganate. Clinical, endoscopic, and histologic features are outlined for each agent in addition to the existing literature. Given the nonspecific presentation of many cases of chemically induced colitis, the diagnosis can be challenging if the pertinent history is not obtained. Most patients demonstrate the resolution of chemical-induced colitis after conservative or medical therapy. Depending on the depth and extent of injury, patients rarely require colectomy for ischemic colitis and/or peritonitis. Other postingestion complications include colonic strictures and rectovaginal fistulae. The benefits of medical therapy compared with conservative therapy are not known, as comparative clinical management trials have not been performed.

Evidence that simulated microgravity may alter the vascular nonreceptor tyrosine kinase second messenger pathway

Simulated microgravity (hind limb unweighting; HU) reduces maximal contractile capacity to norepinephrine (NE) but not 5-hydroxytryptamine (5-HT) in the rat abdominal aorta of male Wistar rats. Our earlier study showed that voltage-operated calcium channels, the MAPK pathway [1], and vasoconstrictive prostaglandins contribute to the NE-induced contraction of control (C) but not HU, aorta rings. Genistein, a general tyrosine kinase inhibitor, caused a significant reduction in vascular contractility in C but not HU arteries. The present study explored the role of protein kinase C (PKC) and extracellular receptor-activated kinase 1 and 2 (ERK1/2) in the HU-induced vascular hyporesponsiveness to NE. Microgravity was simulated in Wistar rats by 20 day HU. The abdominal aorta was removed from control and HU rats, cut into 3 mm rings, and mounted in tissue baths to measure isometric contraction. Protein levels were determined using Western blot analysis. PD98059, a selective MAPKK inhibitor, caused a marked inhibition of NE-induced contraction in both C and HU arteries. Calphostin C, a PKC inhibitor, completely abolished the contractile response to NE in both C and HU tissues. Phosphorylated (activated) ERK1/2 protein mass was greater in C, compared to HU, aortas, and was reduced by genistein only in C tissues. MAPK total protein levels in the rat aorta were increased in the HU-treated, compared to C, animals. These results indicate that PKC represents an early transduction step in the contractile response to NE in the rat abdominal aorta. That inhibition of the step immediately before activation of MAPK reduced contraction in both C and HU tissues, while general tyrosine kinase inhibition with genistein blocked only the control responses, suggests that a nonreceptor tyrosine kinase may be involved in HU-induced vascular hyporesponsiveness to NE.