Insights into the biogeochemical transformation, environmental impacts and biochar-based soil decontamination of antimony.

Every year, a significant amount of antimony (Sb) enters the environment from natural and anthropogenic sources like mining, smelting, industrial operations, ore processing, vehicle emissions, shooting activities, and coal power plants. Humans, plants, animals, and aquatic life are heavily exposed to hazardous Sb or antimonide by either direct consumption or indirect exposure to Sb in the environment. This review summarizes the current knowledge about Sb global occurrence, its fate, distribution, speciation, associated health hazards, and advanced biochar composites studies used for the remediation of soil contaminated with Sb to lessen Sb bioavailability and toxicity in soil. Anionic metal(loid) like Sb in the soil is significantly immobilized by pristine biochar and its composites, reducing their bioavailability. However, a comprehensive review of the impacts of biochar-based composites on soil Sb remediation is needed. Therefore, the current review focuses on (1) the fundamental aspects of Sb global occurrence, global soil Sb contamination, its transformation in soil, and associated health hazards, (2) the role of different biochar-based composites in the immobilization of Sb from soil to increase biochar applicability toward Sb decontamination. The review aids in developing advanced, efficient, and effective engineered biochar composites for Sb remediation by evaluating novel materials and techniques and through sustainable management of Sb-contaminated soil, ultimately reducing its environmental and health risks.

Influence of biochar produced from negative pressure-induced carbonization on transformation of potentially toxic metal(loid)s concerning plant physiological characteristics in industrially contaminated soil.

Soil contamination and its subsequent impact on the food chain is a pressing challenge in the present day. The application of biochar has demonstrated a significant and positive effect on soil health, thereby enhancing plant growth and development. However, the application of biochar (BC) produced from negative pressure-induced carbonization to mitigate metal(loid) contamination is a new strategy that has been studied in current research. Results depicted that the application of biochar derived from the negative pressure carbonization (vacuum-assisted biochar (VBC) has a significant (p ≤ 0.05) positive impact on plant growth and physiological characteristics by influencing immobilization and speciation of metal(loid) in the soil system. Moreover, the interactive effect of VBC on physiological characteristics (photosynthesis, gas exchange, and chlorophyll contents) and antioxidant activities of maize (Zea mays L.) was significantly (p ≤ 0.05) positive by confining the translocation and movement of metal(loid)s to the aerial part of the maize plant. X-ray diffraction (XRD) provided information on the structural and chemical changes induced by the VBC-500 °C explaining metal(loid) adsorption onto mineral surfaces and complexation that can affect their mobility, availability, and toxicity in the contaminated soil. Fourier transform infrared spectroscopy (FTIR) further provided a more detailed understanding of the metal(loid)s and biochar complexation mechanisms influenced by VBC-based functional groups -OH, C-Hn, -COOH, CO, C-O-C, CC, C-O, C-H, OH, and C-C in the binding process. These results suggest that the application of biochar prepared at 500 °C under negative pressure-induced carbonization conditions to the soil is the most efficient way to reduce the uptake and transfer of metal(loid)s by influencing their mobility and availability in the soil-plant system.

Spectroscopic fingerprinting, pollution characterization, and health risk assessment of potentially toxic metals from urban particulate matter.

The unprecedented stride of urbanization and industrialization has given rise to anthropogenic input of tiny particulates into the air. Urban particulate matter (PM) armored with potentially toxic metals (PTMs) could be lethal to the environment and human health. Therefore, the present study was planned to investigate the spectroscopic fingerprinting, pollution status and health risk of PM-associated PTMs collected from ten functional areas of Lahore, Pakistan. The diverged results of studied qualitative and quantitative analyses showed distinct compositional and pollution characteristics of PTMs in urban PM with respect to selected functional areas. The XRD results evident the fractional presence of metal-containing minerals, i.e., pyrite (FeS2), calcite (CaCO3), zinc sulfate (ZnSO4), and chalcostibite (CuSbS2). Several chemical species of Zn, Pb, and As were found in PM of various functional areas. However, morphologies of PM showed anthropogenic influence with slight quantitative support of PTMs presence. The cumulative representation of PTMs pollution of all selected areas depicted that Cd was heavily polluted (Igeo=3.21) while Cr (Igeo=1.82) and Ni (Igeo=2.11) were moderately polluted PTMs. The industrial area having high pollution status of Cd (Igeo=5.54 and EF=18.07), Cu (Igeo=6.4 and EF=32.61), Cr (Igeo=4.03 and EF=6.53), Ni (Igeo=5.7 and EF=20.17), and Zn (Igeo=4.87 and EF=11.27) was prominent among other studied areas. The PTMs were likely to pose a high non-cancerous risk in IndAr (HI = 7.48E+00) and HTV (HI = 1.22E +00) areas predominantly due to Zn with HQ > 1. However, Cr was prominent to cause cancerous risks with values beyond the tolerable range (1.00E-04 to 1.00E-06).

Factors impacting on the decision of graduate entry medical school students to pursue a career in obstetrics and gynecology in Ireland.

BACKGROUND: Challenges in recruiting appropriately trained obstetricians and gynaecologists have been identified across the world. Given well documented staff shortages within obstetrics and gynaecology in Ireland, it is increasingly important to understand the factors which influence medical students to choose or reject a career in the speciality. The aim of this study was to ascertain the perceptions of final year graduate entry medical students of obstetrics and gynaecology, including the factors which may influence a student's decision to pursue in a career in the speciality. METHODS: Paper-based surveys of graduate entry medical students (n = 146) were conducted at the beginning and end of a six week rotation in obstetrics and gynaecology in Ireland. Responses to the surveys pre- and post-rotation were matched and changes in career choices, merits and demerits over time were analysed. All analysis was conducted using SPSS for Windows version 25. RESULTS: The responses of 72 students to both questionnaires could be matched (response rate of 49.3%). No male students expressed an interest in obstetrics, gynaecology or both as a first choice of career in the pre rotation survey. Obstetrics as a first choice of career increased from 6.9% pre rotation to 19.4% post rotation (p = 0.04) and this increase was seen in male and female students. Gynaecology as a first choice increased slightly from 1.4 to 4.2% (p = 0.50) and the dual speciality increased from 6.9 to 13.9% (p = 0.23). Students identified many merits of obstetrics pre-rotation with more than 60% identifying it as exciting, interesting fulfilling and challenging. However, incompatibility with family life was cited as a demerit by 72% of respondents and 68.1% identified fear of litigation as a demerit. Participants were less positive overall about the merits of a career in gynaecology with less than 40% viewing it as exciting, fulfilling, and varied. CONCLUSIONS: While respondents were positive about the merits of a career in obstetrics and gynecology, concerns remain about work-life balance, career opportunities, and the high-risk nature of the specialty. These concerns should be addressed by the profession and policy makers if they wish to attract sufficient numbers to address anticipated need in the coming years. Gender differences in speciality choice were also evident. If males are to be recruited into obstetrics and gynaecology, consideration should be given to the positive impact of internship.

Disparities in esophageal cancer incidence and esophageal adenocarcinoma mortality in the United States over the last 25-40 years.

BACKGROUND: Esophageal carcinoma presents as 2 types, esophageal adenocarcinoma (EAC) and esophageal squamous cell carcinoma (ESCC) with the frequency of both changing in the United States (US). AIM: To investigate EAC/ESCC incidence time trends among the 3 main US racial groups and investigate trends in US EAC survival by ethnicity. METHODS: Twenty-five years (1992-2016) of data from SEER 13 program was analyzed to compare incidence trends in EAC and ESCC between non-Hispanic whites (nHW), non-Hispanic Blacks (nHB) and Hispanics (Hisp) using SEERStat®. In addition, SEER 18 data, from 1975-2015, on EAC in the US was analyzed to evaluate racial disparities in incidence and survival using SEERStat® and Ederer II method. RESULTS: In the 3 major US ethnic groups, age-adjusted incidence of ESCC has declined while EAC has continued to rise from 1992-2016. Of note, in Hisp, the EAC incidence rate increased while ESCC decreased from 1992 to 2016, resulting in EAC as the predominant esophageal cancer subtype in this group since 2011, joining nHW. Furthermore, although ESCC remains the predominant tumor in nHB, the difference between ESCC and EAC has narrowed dramatically over 25 years. EAC survival probabilities were worse in all minority groups compared to nHw. CONCLUSION: Hisp have joined nHW as US ethnic groups more likely to have EAC than ESCC. Of note, EAC incidence in nHB is increasing at the highest rate nationally. Despite lower EAC incidence in all minority groups compared to nHW, these populations have decreased survival compared to nHW.

Antimicrobial activity of the biologically synthesized zinc oxide nanoparticles against important rice pathogens.

Global rice production is seriously affected by many abiotic and biotic factors. Among the aggressive rice pathogens, Xanthomonas oryzae pv. oryzae (X. o. pv. oryzae), Bipolaris oryzae (B. oryzae) and Sphaerulina oryzina (S. oryzina) cause bacterial leaf blight, brown leaf spot and narrow brown leaf spot diseases, respectively. The objective of this study was to evaluate the efficacy of biogenic zinc oxide nanoparticles (ZnO NPs) as antimicrobial agent to control rice pathogens. This is the first report of antifungal activity evaluation of ZnO NPs against B. oryzae and S. oryzina. A pre-characterized bacterial strain Escherichia sp. SINT7 was bio-prospected for synthesis of green ZnO NPs. The NPs were confirmed by a characteristic peak measured at 360.96 nm through UV-Vis spectroscopy. Further, the NPs were characterized to elucidate the surface capping molecules, crystallite structure and morphology by various spectroscopic and imaging techniques, which confirmed the spherical shape of NPs with size ranging from 13.07 to 22.25 nm. In vitro studies against X. o. pv. oryzae pathogen depicted the substantial antibacterial activity (up to 25.7 mm inhibition zone at 20 µg/ml NPs concentration). Similarly, ZnO NPs reduced the mycelial growth of B. oryzae and S. oryzina up to 72.68 and 95.78%, respectively at 50 µg/ml concentration on potato dextrose agar plates, while the mycelial biomass reduction was found to be 64.66 and 68. 49% for B. oryzae and S. oryzina, respectively on potato dextrose broth media as compared to control without the addition of NPs. The green ZnO NPs also significantly reduced the fungal spore germination and a disintegration of fungal hyphae for both fungal strains was observed under the microscope as a result of NPs treatment. Hence, it was concluded that biologically synthesized ZnO NPs are potential antimicrobials and could be compared in greenhouse pathogenicity assays with commercial pesticides to control rice pathogens. Supplementary Information: The online version contains supplementary material available at 10.1007/s12298-022-01251-y.

Sucrase-Isomaltase Deficiency Causing Persistent Bloating and Diarrhea in an Adult Female.

Congenital sucrase isomaltase deficiency (CSID) is an autosomal recessive disorder which leads to chronic intestinal malabsorption of nutrients from ingested starch and sucrose. Symptoms usually present after consumption of fruits, juices, grains, and starches, leading to failure to thrive and malnutrition. Diagnosis is suspected on detailed patient history and confirmed by a disaccharidase assay using small intestinal biopsies or sucrose hydrogen breath test. Treatment of CSID consists of limiting sucrose in diet and replacement therapy with sacrosidase. Due to its nonspecific symptoms, CSID may be undiagnosed in many patients for several years. We present a case of a 50-year-old woman with persistent symptoms of bloating in spite of extensive evaluation and treatment.

Bioinspired green synthesis of silver nanoparticles by using a native Bacillus sp. strain AW1-2: Characterization and antifungal activity against Colletotrichum falcatum Went.

Zero-valent silver nanoparticles (ZV-AgNPs) are known as potential antimicrobials and here we report antifungal activity of ZV-AgNPs against Colletotrichum falcatum Went for the first time. ZV-AgNPs were synthesized by using a native Bacillus sp. strain AW1-2, which was identified through 16S rRNA gene sequence analysis. Biogenic ZV-AgNPs were confirmed by monitoring a characteristic absorption peak of UV-vis spectroscopy that was measured at 447 nm. Further, it was found through FTIR and XRD analysis that ZV-Ag nanocrystals were capped with proteins of bacterial origin and their size ranged from 22.33-41.95 nm. The ultrastructure imaging through scanning electron microscopy (SEM) and transmission electron microscopy (TEM) confirmed the morphology of ZV-AgNPs as mono-dispersed spheres and energy dispersive X-ray spectroscopy (EDX) revealed the dominance of silver (84.21 %) in the nano-powder. The ZV-AgNPs significantly inhibited the hyphal growth of Colletotrichum falcatum Went as compared to non-treated control and commercial fungicide both in solid and broth media. The ultrastructure SEM and TEM studies revealed the disrupted hyphal structure and damage to the internal cellular organelles of Colletotrichum falcatum Went treated with 20 µg mL-1 ZV-AgNPs, respectively. It was concluded that green ZV-AgNPs of bacterial origin could be used to formulate a nano-based fungicide to effectively control Colletotrichum falcatum Went, the causal agent of red rot of sugarcane.

Recent trends in advanced oxidation process-based degradation of erythromycin: Pollution status, eco-toxicity and degradation mechanism in aquatic ecosystems.

Wide spread documentation of antibiotic pollution is becoming a threat to aquatic environment. Erythromycin (ERY), a macrolide belonging antibiotic is at the top of this list with its concentrations ranging between ng/L to a few µg/L in various global waterbodies giving rise to ERY-resistance genes (ERY-RGs) and ERY- resistance bacteria (ERY-RBs) posing serious threat to the aquatic organisms. ERY seems resistant to various conventional water treatments, remained intact and even increased in terms of mass loads after treatment. Enhanced oxidation potential, wide pH range, elevated selectivity, adaptability and greater efficiency makes advance oxidation processes (AOPs) top priority for degrading pollutants with aromatic rings and unsaturated bonds like ERY. In this manuscript, recent developments in AOPs for ERY degradation are reported along with the factors that affect the degradation mechanism. ERY, marked as a risk prioritized macrolide antibiotic by 2015 released European Union watch list, most probably due to its protein inhibition capability considered third most widely used antibiotic. The current review provides a complete ERY overview including the environmental entry sources, concentration in global waters, ERY status in STPs, as well as factors affecting their functionality. Along with that this study presents complete outlook regarding ERY-RGs and provides an in depth detail regarding ERY's potential threats to aquatic biota. This study helps in figuring out the best possible strategy to tackle antibiotic pollution keeping ERY as a model antibiotic because of extreme toxicity records.

Biochar-mediated transformation of titanium dioxide nanoparticles concerning TiO2NPs-biochar interactions, plant traits and tissue accumulation to cell translocation.

Titanium dioxide nanoparticles (TiO2NPs) application in variety of commercial products would likely release these NPs into the environment. The interaction of TiO2NPs with terrestrial plants upon uptake can disturb plants functional traits and can also transfer to the food chain members. In this study, we investigated the impact of TiO2NPs on wheat (Triticum aestivum L.) plants functional traits, primary macronutrients assimilation, and change in the profile of bio-macromolecule. Moreover, the mechanism of biochar-TiO2NPs interaction, immobilization, and tissue accumulation to cell translocation of NPs in plants was also explored. The results indicated that the contents of Ti in wheat tissues was reduced about 3-fold and the Ti transfer rate (per day) was reduced about 2 fold at the 1000 mg L-1 exposure level of TiO2NPs in biochar amended exposure medium. Transmission electron microscopy (TEM) with elemental mapping confirmed that Ti concentrated in plant tissues in nano-form. The interactive effect of TiO2NPs + biochar amendment on photosynthesis related and gas exchange traits was observed at relatively low TiO2NPs exposure level (200 mg L-1), which induced the positive impact on wheat plants proliferation. TiO2NPs alone exposure to wheat also modified the plant's bio-macromolecules profile with the reduction in the assimilation of primary macronutrients, which could affect the food crop nutritional value and quality. X-ray photoelectron spectroscopy (XPS) chemical analysis of biochar + TiO2NPs showed an additional peak, which indicated the binding interaction of NPs with biochar. Moreover, Fourier-transform infrared (FTIR) spectroscopy confirmed that the biochar carboxyl group is the main functionality involved in the bonding process with TiO2NPs. These findings will help for a mechanistic understanding of the role of biochar in the reduction of NPs bioavailability to primary producers of the terrestrial environment.

Decisive role of vacuum-assisted carbonization in valorization of lignin-enriched (Juglans regia-shell) biowaste.

Bioenergy is considered a sustainable substitute to fossil-fuel resources and the development of a prudent combination of renewable and innovative conversion technologies are essential for the valorization and effective conversion of biowaste to value-added commodities. Here, a negative pressure-induced carbonization process was proposed for the valorization of lignin-enriched biowaste precursor to bio-oil and environmental materials (biochar) at various temperatures. The high heating values (HHV) of the as-prepared biochars from the lignin enriched precursor under negative pressure (low-medium vacuum) were within 25.9-31.5 MJ/kg, which matched satisfactorily to the commercial charcoal. Whereas, the bio-oils produced from the lignin enriched precursor under vacuum conditions was a blend of complex aromatic and straight-chain hydro-carbons, including aldehyde, ketone, phenol, and furans, exhibiting ability as potential heating-oil with HHV within 21.2-28.2 MJ/kg. Moreover, the biochars produced under vacuum environments at higher temperature showed greater stability (22.5-35.9%) than those produced under N2 atmosphere.

Strategies for arsenic pollution control from copper pyrometallurgy based on the study of arsenic sources, emission pathways and speciation characterization in copper flash smelting systems.

Arsenic in copper flash smelting (FS) systems not only affects the quality of products but also poses significant technological and environmental problems. Based on the assessment of arsenic mass partitioning in the FS system, arsenic elimination in off-gassing and tailings is 22%, and most of the arsenic output (69%) is recycled in the FS system. Circulating arsenic, especially arsenic in recycled dust and slag concentrate, is the key reason for high-arsenic-content feed. Dust-type recycled materials (RMs) contribute much more arsenic to the feed than slag-type RMs. Flash smelting furnace electrostatic precipitator (FSF ESP) dust contributes makese the largest contribution to arsenic among the dust-type RMs of mixed dust, especially trivalent arsenic, followed by FSF and flash converting furnace waste heat boiler (FCF WHB) dust, which contributes pentavalent arsenic. FCF WHB dust exhibits a relatively low arsenic content, consisting mainly of As(V)-O. Slag-type recycled materials contribute As(V)-O to the total feed, and As(III) originates from copper concentrates. Considering the arsenic contribution and environmental risk, reducing the recovery of FSF ESP dust can greatly decrease the arsenic grade of FSF feed and volatile As2O3. As one of the main arsenic sources in feed, FSF slag concentrate should be carefully disposed of if separated from feed materials because of its high arsenic-related environmental risk. In contrast, WHB dust and FCF slag are more suitable as RM due to their high copper content and low arsenic risk.

Heterologous expression of azoreductase-encoding gene azrS of Bacillus sp. MR-1/2 for enhanced azo dye decolorization and wastewater treatment.

In Pakistan, 55% of textile exports are contributed by textile-units of Faisalabad. The effluents of these textile units, being discharged without any treatment, contain the contamination of a huge amount of synthetic azo dyes. The objective of the current research was to evaluate the contribution of an azoreductase-encoding gene (azrS) from a pre-characterized azo dye decolorizing bacterial strain Bacillus sp. MR-1/2 in a high copy number host system (pUC19-T7-Top-T) of Escherichia coli strain DH5α followed by in-silico prediction of azoreductase enzyme (AzrS) function. The recombinant cells that contained azrS had a significantly higher rate of color removal in congo red and reactive black-5 dyes when compared to wild-type MR-1/2 and E. coli DH5α after 72 h of incubation. Moreover, we were able to show that the recombinant strain significantly reduced the values of all tested parameters (pH, EC, turbidity, TSS, and COD) in actual wastewater. In support of our results, it was also predicted through bioinformatics analysis that the deduced azoreductase protein of strain MR-1/2 is linked with the dye decolorization ability of the strain through NAD(P)H-ubiquinone: oxidoreductase activity. Furthermore, we also found that the deduced protein resembled closely related proteins of protein databank in many features, yet some unique features were predicted in the enzyme activity of strain MR-1/2. It was concluded that the recombinant strain could be examined in pilot-scale experiments for textile wastewater treatment.

Bamboo-biochar and hydrothermally treated-coal mediated geochemical speciation, transformation and uptake of Cd, Cr, and Pb in a polymetal(iod)s-contaminated mine soil.

In this study, polymetal(iod)s-contaminated mining soil from the Huainan coalfield, Anhui, China, was used to investigate the synergistic effects of biochar (BC), raw coal (RC), and hydrothermally treated coal (HTC) on the immobilization, speciation, transformation, and accumulation of Cd, Cr, and Pb in a soil-plant system via geochemical speciation and advanced spectroscopic approaches. The results revealed that the BC-2% and BC-HTC amendments were more effective than the individual RC, and/or HTC amendments to reduce ethylene-diamine-tetraacetic acid (EDTA)-extractable Cd, Cr, and Pb concentrations by elevating soil pH and soil organic carbon content. Soil pH increased by 1.5 and 2.5 units after BC-2% and BC-HTC amendments, respectively, which reduced EDTA-extractable Cd, Cr, and Pb to more stabilized forms. Metal speciation and X-ray photoelectron spectroscopy analyses suggested that the BC-HTC amendment stimulated the transformation of reactive Cd, Cr, and Pb (exchangeable and carbonate-bound) states to less reachable (oxide and residual) states to decrease the toxicity of these heavy metals. Fourier transform infrared spectroscopy and X-ray diffraction analyses suggested that reduction and adsorption by soil colloids may be involved in the mechanism of Cd(II), Cr(VI), and Pb(II) immobilization via hydroxyl, carbonyl, carboxyl, and amide groups in the BC and HTC. Additionally, the BC-2% and BC-HTC amendments reduced Cd and Pb accumulation in maize shoots, which could mainly be ascribed to the reduction of EDTA-extractable heavy metals in the soil and more functional groups in the roots, thus inhibiting metal ion translocation by providing the electrons necessary for immobilization, compared to those in roots grown in the unamended soil. Therefore, the combined application of BC and HTC was more effective than the individual application of these amendments to minimize the leaching, availability, and exchangeable states of Cd, Cr, and Pb in polymetal(iod)s-contaminated mining soil and accumulation in maize.

Left Bundle Branch Block Chest Pain Conundrum.

Left bundle branch block is a pattern of altered ventricular depolarization and subsequently affects repolarization. These obscure patterns can affect the traditional ST segment shift criteria for the electrocardiographic detection of coronary insufficiency syndromes. Previously, patients with coronary ischemic pain and LBBB judged to be "new" (not previously documented) were considered to have ST elevation myocardial infarction (STEMI) warranting acute thrombolytic therapy. Current STEMI management favors emergent invasive angiography; however, recent data suggests the prevalence of coronary obstructive pathology may be as low as 50%. The application of more specific, less-sensitive Sgarbossa electrocardiographic criteria may reduce angiographic assessment in an otherwise high-risk population unlikely to tolerate further myocardial injury. We present a case that may facilitate a more nuanced EKG-based approach to distinguish those who may benefit from acute invasive angiography while reducing the frequency of unnecessary angiographic evaluation.

Contrasting effects of biochar and hydrothermally treated coal gangue on leachability, bioavailability, speciation and accumulation of heavy metals by rapeseed in copper mine tailings.

The purpose of this research was to examine the influence of hydrothermally treated coal gangue (HTCG) with and without biochar (BC) on the leaching, bioavailability, and redistribution of chemical fractions of heavy metals (HMs) in copper mine tailing (Cu-MT). An increase in pH, water holding capacity (WHC) and soil organic carbon (SOC) were observed due to the addition of BC in combination with raw coal gangue (RCG) and HTCG. A high Cu and other HMs concentration in pore water (PW) and amended Cu-MT were reduced by the combination of BC with RCG and/or HTCG, whereas individual application of RCG slightly increased the Cu, Cd, and Zn leaching and bioavailability, compared to the unamended Cu-MT. Sequential extractions results showed a reduction in the exchangeable fraction of Cu, Cd, Pb, and Zn and elevation in the residual fraction following the addition of BC-2% and BC-HTCG. However, individual application of RCG slightly increased the Cu, Cd, and Zn exchangeable fractions assessed by chemical extraction method. Rapeseed was grown for the following 45 days during which physiological parameters, metal uptake transfer rate (TR), bioconcentration factor (BCF), and translocation factor (TF) were measured after harvesting. In the case of plant biomass, no significant difference between applied amendments was observed for the fresh biomass (FBM) and dry biomass (DBM) of shoots and roots of rapeseed. However, BC-2% and BC-HTCG presented the lowest HMs uptake, TR, BCF (BCFroot and BCFshoot), and TF for Cu, Cd, Cr, Ni, Pb, and Zn in rapeseed among the other amendments compared to the unamended Cu-MT. Overall, these findings are indicative that using biochar in combination with RCG and/or HTCG led to a larger reduction in HMs leaching and bioavailability, due to their higher sorption capacity and could be a suitable remediation strategy for heavy metals in a Cu-MT.

A comprehensive review of biogeochemical distribution and fractionation of lead isotopes for source tracing in distinct interactive environmental compartments.

Lead (Pb) is a non-essential and extremely noxious metallic-element whose biogeochemical cycle has been influenced predominantly by increasing human activities to a great extent. The introduction and enrichment of this ubiquitous contaminant in the terrestrial-environment has a long history and getting more attention due to its adverse health effects to living organisms even at very low exposure levels. Its lethal-effects can vary widely depending on the atmospheric-depositions, fates and distribution of Pb isotopes (i.e., 204Pb, 206Pb, 207Pb &208Pb) in the terrestrial-environment. Thus, it is essential to understand the depositional behavior and transformation mechanism of Pb and the factors affecting Pb isotopes composition in the terrestrial-compartments. Owing to the persistence nature of Pb-isotopic fractions, regardless of ongoing biogeochemical-processes taking place in soils and in other interlinked terrestrial-compartments of the biosphere makes Pb isotope ratios (Pb-IRs) more recognizable as a powerful and an efficient-tool for tracing the source(s) and helped uncover pertinent migration and transformation processes. This review discusses the ongoing developments in tracing migration pathway and distribution of lead in various terrestrial-compartments and investigates the processes regulating the Pb isotope geochemistry taking into account the source identification of lead, its transformation among miscellaneous terrestrial-compartments and detoxification mechanism in soil-plant system. Additionally, this compendium reveals that Pb-pools in various terrestrial-compartments differ in Pb isotopic fractionations. In order to improve understanding of partition behaviors and biogeochemical pathways of Pb isotope in the terrestrial environment, future works should involve investigation of changes in Pb isotopic compositions during weathering processes and atmospheric-biological sub-cycles.

Median Arcuate Ligament Syndrome: It Is Not Always Gastritis.

Median arcuate ligament syndrome is a rare disorder that is clinically characterized by the triad of postprandial abdominal pain, weight loss, and often an abdominal bruit due to compression of the celiac artery by the median arcuate ligament. Given the nonspecific symptoms, this is a rare and difficult diagnosis to obtain. We present a patient with nonspecific abdominal pain in whom etiology was ultimately determined to be median arcuate ligament syndrome.

Predictors of quality of life among women with coronary heart disease.

BACKGROUND: Health-related quality of life (HRQOL) is an increasingly relevant outcome as the population ages and associated morbidities increase. The purpose of this study was to evaluate predictors of HRQOL among ethnically diverse women hospitalized for coronary heart disease (CHD) and determine the impact of a brief, educational intervention on HRQOL 6 months post-hospitalization. METHODS: Women (n = 160; mean age 63 years, 53% minority) admitted for CHD at three academic hospitals who completed a 6 month secondary prevention trial were studied. The SF-36 was administered at admission and 6 months. Multiple linear regressions were used to identify significant independent predictors of 6 month HRQOL. RESULTS: Significant improvements in HRQOL were noted from admission to 6 months post-hospitalization. Subjects reporting better HRQOL at 6 months included those who were employed, married, physically active, enrolled in cardiac rehabilitation, and not depressed. Women who received an educational intervention had significantly less bodily pain at 6 months compared with usual care in a model adjusted for baseline HRQOL and physical activity goal adherence (p = 0.04). CONCLUSIONS: Baseline HRQOL (8 SF-36 subscales), physical activity (3 SF-36 subscales) and marital status (1 SF-36 subscale) were the major determinants of HRQOL at 6 months post-hospitalization. Future interventions and preventive efforts should be targeted to women with CHD who have impaired HRQOL and may be at increased risk of poor clinical outcomes.

Effect of diabetes on short- and long-term outcomes after left ventricular assist device implantation.

BACKGROUND: Diabetes mellitus (DM) is a frequent co-morbidity in patients with congestive heart failure (CHF). Implantation of LVADs is an acceptable option for diabetic patients with end-stage heart failure, yet no previous study has specifically examined the clinical outcomes of this patient population. METHODS: A retrospective analysis was performed on all patients who underwent LVAD insertion at a single institution from June 17, 1996 to April 14, 2004. Patients were divided into 2 groups: diabetics (DM) and non-diabetics (NDM). The groups were compared with regard to demographics, etiology of heart failure, body mass index (BMI), intensive care unit (ICU) stay, early mortality (< or =30 days), bridge-to-transplantation rate and post-LVAD and post-transplant survival. RESULTS: Two hundred one patients were identified. Of these, 49 (24.4%) had DM. Compared with the NDM group, DM patients had a higher mean body mass index (30.1 +/- 6.0 vs 26.1 +/- 4.8, p < 0.001) and a higher proportion of hypertension (57.4% vs 19.7%, p < 0.001). Although post-LVAD survival was similar, post-transplant survival in DM patients was significantly lower compared with NDM patients, with 1-, 3-, 5- and 7-year actuarial survival rates of 86.9%, 71.0%, 56.5% and 56.5% vs 90.5%, 88.4%, 83.0% and 80.7% (p = 0.020), respectively. CONCLUSIONS: Carefully selected diabetic patients can be successfully bridged to transplantation using LVADs with comparable outcomes to non-diabetic patients. Reasons for diminished post-transplant survival in this cohort are unclear and necessitate the conductance of multi-institutional studies to evaluate outcomes.