Innovative biopolyelectrolytes-based technologies for wastewater treatment.

Developing eco-friendly, cost-effective, and efficient methods for treating water pollutants has become paramount in recent years. Biopolyelectrolytes (BPEs), comprising natural polymers like chitosan, alginate, and cellulose, have emerged as versatile tools in this pursuit. This review offers a comprehensive exploration of the diverse roles of BPEs in combating water contamination, spanning coagulation-flocculation, adsorption, and filtration membrane techniques. With ionizable functional groups, BPEs exhibit promise in removing heavy metals, dyes, and various pollutants. Studies showcase the efficacy of chitosan, alginate, and pectin in achieving notable removal rates. BPEs efficiently adsorb heavy metal ions, dyes, and pesticides, leveraging robust adsorption capacity and exceptional mechanical properties. Furthermore, BPEs play a pivotal role in filtration membrane techniques, offering efficient separation systems with high removal rates and low energy consumption. Despite challenges related to production costs and property variability, their environmentally friendly, biodegradable, renewable, and recyclable nature positions BPEs as compelling candidates for sustainable water treatment technologies. This review delves deeper into BPEs' modification and integration with other materials; these natural polymers hold substantial promise in revolutionizing the landscape of water treatment technologies, offering eco-conscious solutions to address the pressing global issue of water pollution.

A Descriptive Qualitative Study of the Perceptions of Regulatory Authorities, Parents, and School Canteen Owners in the South of Ecuador about the Challenges and Facilities Related to Compliance with the National Regulation for School Canteens.

The prevalence of overweight and obesity in the Ecuadorian school population continues to increase. An important factor in children's nutrition is the food offered in school canteens. The objective of this study was to explore the perceptions of the challenges faced by and facilities of school canteens in the provinces of southern Ecuador in terms of complying with national regulations. For this qualitative descriptive study, semi-structured interviews were conducted in 2021 with six school canteen owners, six school directors, five health experts, and seven parents of children attending school from three provinces, Cañar, Azuay, and Morona Santiago, in Ecuador. The data were transcribed and subsequently analyzed in ATLAS ti. The participants indicated several challenges to comply with the regulations of school canteens, such as the expenses generated by them, the lack of control of street food vendors in the surroundings of the schools, and the lack of trained personnel. Regarding the facilities, they highlighted that the regulation for cleaning and hygiene are more easily fulfilled. Standards and control of the food stipend in school canteens are required to ensure a supply of healthy food for the children. Multiple challenges and strategies are proposed to improve the eating habits of the school population and to improve the nutrition of schoolchildren.

Occurrence of emerging contaminants in surface water bodies of a coastal province in Ecuador and possible influence of tourism decline caused by COVID-19 lockdown.

Emerging contaminants in water bodies is an issue of concern due to their impact on the ecosystem and human health. The COVID-19 pandemic has forced the implementation of protective measures such as social distancing, lockdowns, and remote work, which have affected the tourism influx. This study aimed to evaluate the occurrence of emerging pollutants in bodies of water in Esmeraldas, a coastal province of Ecuador, before and during the COVID-19 pandemic in a highly touristic region. For this purpose, surface waters from 14 beaches and ten river mouths were sampled at two-time points in November 2019 and November 2020. Compounds widely consumed in Ecuador: acetaminophen, caffeine, sodium diclofenac, trimethoprim, and sulfamethoxazole were extracted from water samples by solid phase extraction SPE and detected with a UPLC-QTOF-MS system. We found a decrease in the occurrence of caffeine from 100 % to 4.2 % of caffeine and 25 % to 0 % of diclofenac, likely related to the decline in tourist afflux due to the lockdown measures. Most of the compounds diminished in terms of frequency and/or concentration; however, as COVID-19 treatments make use of different pharmaceutical compounds such as antivirals, antibiotics, antiparasitics, or glucocorticoids, future studies should include these to assess their environmental impact.

Human health risk assessment of metals and metalloids in mining areas of the Northeast Andean foothills of the Ecuadorian Amazon.

Gold mining (GM) is a major source of metals and metalloids in rivers, causing severe environmental pollution and increasing the exposure risks to the residents of surrounding areas. Mining in Ecuadorian Amazonia has dramatically increased in recent years, but its impacts on Indigenous local populations that make use of rivers are still unknown. The aim of this study was to assess the risks to adults and children caused by the exposure to metals and metalloids in freshwater ecosystems contaminated with tailings released by GM activities in 11 sites of the upper Napo River basin, Ecuador. We selected a carcinogenic and a noncarcinogenic risk assessment method to estimate the hazard index (HI) and total cancer risk (TCR). The concentration of Ag, Al, As, Cd, Cu, Fe, Mn, Pb, Zn, B, and V in water and sediment samples was considered to assess the risks to human health. The calculated HI was 23-352 times greater than the acceptable limits in all sites for both children and adults. Mn and Fe were the main contributors (75% in water and 99% in sediment) to the total calculated risk based on the HI. The calculated TCR for children and adults exceeded approximately one to three times the permissible threshold in all sites. As and Pb contributed up to 93% of the total calculated risk based on TCR for both children and adults. This study demonstrates that the emission and mobilization of metals and metalloids caused by mining activities increase the risk to human health, to which we recommend further monitoring of freshwater contamination in the area and the implementation of preventive health management measures. Integr Environ Assess Manag 2023;19:706-716. © 2022 The Authors. Integrated Environmental Assessment and Management published by Wiley Periodicals LLC on behalf of Society of Environmental Toxicology & Chemistry (SETAC).

Acute Toxicity of Daphnia magna Neonates Exposed to Single and Composite Mixtures of Four Emerging Contaminants.

The effects of emerging contaminants on environmental health are of high concern, especially those potentially induced by mixtures. We assessed single and composite mixtures of triclosan (T), 17ß-estradiol (E2), sulfamethoxazole (SMX), and nicotine (N) at various concentrations, on neonates of Daphnia magna. When used in single exposure, T and N induced high toxicity (100% immobility, each one), compared to SMX and E2 (2.5% and 10% immobility, respectively). When T, E2, SMX and N were in mixture, T had the highest contribution to the overall toxicity in mixture exposures. The N toxicity lowered when in a fourfold exposure (85% immobility in fourfold exposure). Due to the high toxicity of T and N, both alone and in the mixtures, our results can serve as a warning about the use of these substances and their release in the aquatic ecosystem.

Insights into Palladium Deactivation during Advanced Oxidation Processes.

A key step in creating efficient and long-lasting catalysts is understanding their deactivation mechanism(s). On this basis, the behavior of a series of Pd/corundum materials during several hydrogen adsorption/desorption cycles was studied using temperature-programmed desorption coupled with mass spectrometry and aberration-corrected transmission electron microscopy. The materials, prepared by impregnation and by sputtering, presented uniform well-dispersed Pd nanoparticles. In addition, single atoms and small clusters of Pd were only detected in the materials prepared by impregnation. Upon exposure to hydrogen, the Pd nanoparticles smaller than 2 nm and the single atoms did not present any change, while the larger ones presented a core-shell morphology, where the core was Pd and the shell was PdH x . The results suggest that the long-term activity of the materials prepared by impregnation can be attributed solely to the presence of small clusters and single atoms of Pd.

Safety and efficacy of convalescent plasma for severe COVID-19: a randomized, single blinded, parallel, controlled clinical study.

BACKGROUND: Convalescent plasma (CP) has been widely used to treat COVID-19 and is under study. However, the variability in the current clinical trials has averted its wide use in the current pandemic. We aimed to evaluate the safety and efficacy of CP in severe coronavirus disease 2019 (COVID-19) in the early stages of the disease. METHODS: A randomized controlled clinical study was conducted on 101 patients admitted to the hospital with confirmed severe COVID-19. Most participants had less than 14 days from symptoms onset and less than seven days from hospitalization. Fifty patients were assigned to receive CP plus standard therapy (ST), and 51 were assigned to receive ST alone. Participants in the CP arm received two doses of 250 mL each, transfused 24 h apart. All transfused plasma was obtained from "super donors" that fulfilled the following criteria: titers of anti-SARS-CoV-2 S1 IgG ≥ 1:3200 and IgA ≥ 1:800 antibodies. The effect of transfused anti-IFN antibodies and the SARS-CoV-2 variants at the entry of the study on the overall CP efficacy was evaluated. The primary outcomes were the reduction in viral load and the increase in IgG and IgA antibodies at 28 days of follow-up. The per-protocol analysis included 91 patients. RESULTS: An early but transient increase in IgG anti-S1-SARS-CoV-2 antibody levels at day 4 post-transfusion was observed (Estimated difference [ED], - 1.36; 95% CI, - 2.33 to - 0.39; P = 0.04). However, CP was not associated with viral load reduction in any of the points evaluated. Analysis of secondary outcomes revealed that those patients in the CP arm disclosed a shorter time to discharge (ED adjusted for mortality, 3.1 days; 95% CI, 0.20 to 5.94; P = 0.0361) or a reduction of 2 points on the WHO scale when compared with the ST group (HR adjusted for mortality, 1.6; 95% CI, 1.03 to 2.5; P = 0.0376). There were no benefits from CP on the rates of intensive care unit admission (HR, 0.82; 95% CI, 0.35 to 1.9; P = 0.6399), mechanical ventilation (HR, 0.66; 95% CI, 0.25 to 1.7; P = 0.4039), or mortality (HR, 3.2; 95% CI, 0.64 to 16; P = 0.1584). Anti-IFN antibodies and SARS-CoV-2 variants did not influence these results. CONCLUSION: CP was not associated with viral load reduction, despite the early increase in IgG anti-SARS-CoV-2 antibodies. However, CP is safe and could be a therapeutic option to reduce the hospital length of stay. Trial registration NCT04332835.

Laparoscopic Gastric Band Placement in Combination With Sleeve Gastrectomy for Advanced Weight Loss: A Case Report.

Laparoscopic adjustable gastric banding (LAGB) over laparoscopic sleeve gastrectomy (LSG) is a rare bariatric surgery. The objective of this case report is to add to the limited literature regarding this procedure. LAGB plus LSG is an effective bariatric procedure for patients that desire additional weight loss who do not qualify for or want gastric bypass. A 39-year-old African American Female with a pertinent past medical history of morbid obesity, gastroesophageal reflux disease (GERD), sleep apnea, and chronic back pain presents for gastric bypass consultation in 2020. The patient had a prior bariatric surgical history of gastric band placement (2014), removal (2016), and LSG (2018). The patient was unsatisfied with her weight loss and pursued a consultation for gastric bypass. Upon further investigation, gastric bypass was not indicated for the patient due to low BMI. The patient was presented with the option of LAGB over LSG for increased weight loss and improvement or resolution of comorbid conditions. The patient appreciated the physicians' recommendation, and on June 3, 2021, a LAGB was placed over the prior sleeve gastrectomy. No complications occurred preoperatively or postoperatively. The patient continues to adhere to diet and exercise instructions, and at her most recent follow-up, she reported resolution of GERD symptoms and had a reduced BMI of 33.2. It is important to note that the long-term outcomes of this procedure are yet to be fully discovered due to the rarity of the surgery and some literature deficiencies. Overall, LAGB, in combination with LSG, is a safe and effective procedure for increasing weight loss, improving quality of life, and decreasing mortality for patients for whom the surgery is indicated.

Fournier's Gangrene in a Female Diabetic Patient: A Case Report.

Necrotizing fasciitis is a rare but potentially fatal deep infection involving subcutaneous tissue and fascia. The infection can occur in all parts of the body and can cause acute onset pain, swelling, fever, malaise, and tachycardia with or without evidence of skin inflammation. Risk factors include recent surgery, diabetes, trauma, intravenous drug use, alcoholism, and chronic illnesses. This case involves a 35-year-old female with a past medical history of hypertension, type II diabetes mellitus, and obesity presenting with a painful vulvar lump, which progressed rapidly into extensive necrotizing soft tissue infection despite the incision and drainage of the vulvar abscess, marsupialization, and antibiotic therapy. The patient underwent multiple surgical debridements with intense medical treatment and wound vacuum-assisted closure therapy. Uncontrolled diabetes and obesity significantly increase the risk of necrotizing fasciitis. Fournier's gangrene should be suspected in patients with comorbid conditions and a presentation of a urogenital abscess. This case highlights the importance of prompt diagnosis and treatment of necrotizing fasciitis in a timely manner.

Operational Effect of COVID-19 on Surgical Care at a Tertiary Pediatric Hospital.

The detrimental effects of the coronavirus disease 2019 (COVID-19) pandemic have profoundly disrupted surgical care at health care facilities worldwide. At our tertiary pediatric hospital, we made substantial adjustments to surgical suite utilization and staff member scheduling to account for reductions in surgical volume, increased demand for staff members in other sectors of the hospital, and the highly infectious properties of the virus. Perioperative leaders took advantage of the pandemic's disruption to clinical activities to design and implement a new procedure-scheduling process to rectify the inefficiencies that had accumulated as the previous system evolved. The implementation of said directives was largely facilitated by establishing communication with all involved parties for their input and feedback throughout the process. Although COVID-19 has had varying effects on procedural operations across pediatric health care facilities, we believe our institutional response to the disruptive forces of COVID-19 is of benefit to pediatric hospitals worldwide.

Mesh for Hernia Repair as Cause of Bowel Obstruction.

Ventral hernia repairs are commonly treated by abdominal wall repair where a prosthetic mesh is placed over the hernia site, to prevent future hernia recurrences. Risks of a ventral hernia repair include urinary retention, seroma, recurrence, and in rare cases, bowel injury or obstruction. Our patient's clinical presentation and history, supported by an abdominal X-ray and CT findings, were consistent with the diagnosis of small bowel obstruction (SBO) due to adhesions between the patient's small bowel and the mesh used for abdominal wall hernia repair. Our patient underwent an exploratory laparotomy due to exquisite abdominal wall tenderness and evidence of SBO. Appropriate identification of the cause of our patient's SBO, careful and meticulous treatment, and appropriate inpatient monitoring all contributed to a successful outcome.

Chronic Appendicitis, the Lesser-Known Form of Appendiceal Inflammation: A Case Report.

Chronic appendicitis is a rare condition involving appendiceal inflammation as these conditions typically present acutely and are treated with appendectomy. However, in a small minority of patients, appendicitis can have a mild presentation and become recurrent or chronic appendicitis. Due to the acute nature and immediate treatment of patients presenting with typical symptoms of appendicitis, chronic appendicitis has been often overlooked and/or misdiagnosed. We present a case in which a 50-year-old male presented with right lower quadrant (RLQ) pain of one-month duration. Computed tomography (CT) imaging showed evidence of lymph node enlargement near the patient's appendix, raising suspicion of chronic appendicitis. The patient underwent a successful laparoscopic appendectomy.

Microplastics in rivers and coastal waters of the province of Esmeraldas, Ecuador.

This study represents the first assessment of microplastic (MP) contamination in the coastal area of the Esmeraldas Province, Ecuador. MPs were quantified in 14 coastal waters in beaches with different urbanization level and in 10 rivers. The most abundant MP types were transparent fibres, brown fragments, grey fragments, transparent fragments, and black fragments, which together represented 84% of the total count. Coastal waters presented significantly higher quantities of MP than rivers. No difference in microplastic abundance was detected between beaches with higher and lower urban occupation, nor between beaches facing North or West. Our results indicate that MP contamination is widespread, and most likely transported from multiple sources. Our results can serve as a baseline for future MP monitoring in the area.

Diffuse Nickel Hypersensitivity Reaction Post-cholecystectomy in a Young Female.

Nickel, a silvery-hard metallic element used in corrosion-resistant alloys, is widely used in the medical field. Nickel has aided in medical advancements; however, it has been known to cause hypersensitivity reactions. Retained foreign bodies due to surgical procedures may cause postoperative complications such as allergic reactions. This case involves a 30-year-old female presenting with non-specific symptoms involving multiple organ systems, notably with abdominal pain. Due to chronic symptoms, the patient was tested for metal allergies and diagnosed with hypersensitivity reactions to nickel surgical clips that were previously inserted during cholecystectomy. Subsequently, the patient had surgical removal of the foreign bodies, which led to significant improvement of her symptoms immediately. This case demonstrates a delayed hypersensitivity reaction to a foreign body involving multiple body systems and vague symptoms making the diagnosis challenging. It is important to carefully evaluate the patient's past medical history including history of any allergies. It also brings attention to the necessity of performing metal skin patch tests preoperatively for individuals with a history of any type of allergies.

An Integrative Approach to Assess the Environmental Impacts of Gold Mining Contamination in the Amazon.

As the number of legal and illegal gold mining sites increases in the Andes-Amazonia region, integrative methods to evaluate the effects of mining pollution on freshwater ecosystems are of paramount importance. Here, we sampled water and sediments in 11 sites potentially affected by gold mining activities in the Napo province (Ecuador). The environmental impacts were evaluated using the following lines of evidence (LOEs): water physicochemical parameters, metal exposure concentrations, macroinvertebrate community response (AAMBI), and toxicity by conducting bioassays with Lactuca sativa and Daphnia magna. Dissolved oxygen and total suspended solids were under (<80%) and above (>130 mg/Ls) quality standards 65% of the sites. Ag, Al, As, Cd, Cu, Fe, Mn, Pb, and Zn in water and V, B, and Cr in sediments were detected above quality standards at sampled sites. Nine out of eleven sites were classified as having bad environmental quality based on the AAMBI. L. sativa seed germination in both water (37% to 70%) and sediment (0% to 65%) indicate significant toxicity. In five sites, neonates of D. magna showed a 25% reduction in survival compared to the control. Our integrated LOEs index ranked sites regarding their environmental degradation. We recommend environmental impact monitoring of the mining expansion at the Andes-Amazonia region using multiple LOEs.

Emerging Contaminants in the Northeast Andean Foothills of Amazonia: The Case of Study of the City of Tena, Napo, Ecuador.

This work is a study on the occurrence of emerging pollutants in the northeast Ecuadorian Amazon. Emerging contaminants (ECs)-caffeine, triclosan, estradiol, acetaminophen, nicotine, and ibuprofen-were quantified by gas chromatography-mass spectrometry in rivers and streams of the Amazon basin near the city of Tena, Ecuador. For that, a total of 16 natural water samples were taken in 8 locations. Sampling sites included areas impacted by discharges from inefficient sewage networks in urban areas, wastes from fish farming and non-functional landfill, a stream with few threats, tap water, and treated sewage. Caffeine was found in the 38% of the samples studied while trimethoprim and acetaminophen had an occurrence of 13%. Caffeine was detected at two sites receiving untreated sewage and one site receiving treated sewage with mean concentrations that ranged between 19 and 31.5 µg L-1. Acetaminophen (50.4 µg L-1) and trimethoprim (2 µg L-1) were only detected in the river receiving treated sewage effluent. This is the first assessment of emerging contaminants in the upper Ecuadorian Amazon basin, and our observations highlight the need for better sewage treatment and water quality monitoring in Amazonian cities.

Genotoxicity of organic material extracted from particulate matter of alternative fuels.

Global demand for energy is rapidly increasing, and resources for the production of petroleum-based fuels are running out. For this, renewable fuels like biodiesel and hydrotreated vegetable oil biofuel are considered important alternatives to replace such fuels. In this study, we evaluated the in vitro genotoxicity effect on HepG2 cells of organic material extracted from particulate matter emissions of an engine fueled with conventional diesel or mixtures of diesel with 10% of biomass. The emissions were collected in two operational modes, 2410 rpm (slope simulation) and 1890 rpm (plane). Genotoxicity was evaluated through two methods, chromosomal aberration test and the alkaline comet assay. The former did not show any genotoxic effect, but the latter exhibited a statistically significant effect despite the operational mode of the engine and the concentration organic material extracted. In conclusion, regardless of the concentration of organic material extracted from particulate matter, the operational mode of the engine, or the fuel used, a significant damage of the DNA was found. In general, at the physicochemical level, a decrease in the amount of emissions of the used fuels is not directly related to a decrease in the genotoxicity potential.

Cholecystoduodenal Fistula Evading Imaging and Endoscopic Retrograde Cholangiopancreatography: A Case Report.

Cholecystoduodenal fistulas are a type of internal biliary fistula that occur due to chronic inflammation of the gallbladder/biliary tree; if left untreated, perforation and necrosis can occur. Cholecystoduodenal fistulas are often difficult to diagnose due to their non-specific signs and symptoms. Since the widespread use of techniques such as magnetic resonance cholangiopancreatography and imaging modalities such as computed tomography, the frequency of reports describing intraoperative cholecystoduodenal fistula has reduced dramatically. Here, we report the case of a 54-year-old female who presented with a two-day history of non-radiating epigastric abdominal pain, initially diagnosed with acute cholecystitis and choledocholithiasis. Upon undergoing laparoscopic cholecystectomy, she was found to have extensive fibrosis of the gallbladder, adhesions, and an impacted gallstone in the wall of the gallbladder. Imaging and endoscopic retrograde cholangiopancreatography performed prior to surgery did not detect a cholecystoduodenal fistula that was discovered intraoperatively. She was treated successfully with laparoscopic cholecystectomy and repair of the duodenum.

Disseminated Streptococcus bovis infection after consumption of manatee meat: A case report and review of the literature.

Streptococcus bovis bacteremia (currently called S. gallolyticus) represents an infrequent condition, but associated with a high rate of morbidity and mortality Amado et al. (2015). The clinical presentation is characterized by symptoms associated with disseminated infection and with a higher frequency of endocarditis and gastrointestinal neoplasms, often occult Amado et al. (2015), Olmos et al. (2016). Probable sources of infection and zoonotic transmission have not been explored in the literature. We present a case of disseminated infection after ingestion of a marine mammal.