Equilibrium, kinetic, and thermodynamic studies on the biosorption of lead by human metallothionein gene-cloned bacteria as a novel biosorbent.

Heavy metals are the main pollutants in water and are an important global problem that threatens human health and ecosystems. In recent years, there has been an increasing interest in the use of genetically modified bacteria as an eco-friendly method to solve heavy metal pollution problems. The goal of this study was to generate genetically modified Escherichia coli expressing human metallothioneins (hMT2A and hMT3) and to determine their tolerance, bioaccumulation, and biosorption capacity to lead (Pb2+ ). Recombinant MT2A and MT3 strains expressing MT were successfully generated. Minimum inhibition concentrations (MIC) of Pb for MT2A and MT3 were found to be 1750 and 2000 mg L-1 , respectively. Pb2+ resistance and bioaccumulation capacity of MT3 were higher than MT2A. Therefore, only MT3 biosorbent was used in Pb2+ biosorption, and its efficiency was examined by performing experiments in a batch system. Pb2+ biosorption by MT3 was evaluated in terms of isotherms, kinetics, and thermodynamics. The results showed that Pb biosorption fits to the Langmuir isotherm model and the pseudo-first-order kinetic model, and the reaction is exothermic. The maximum Pb2+ capacity of the biosorbent was 50 mg Pb2+ g-1 . The potential of MT3 in Pb biosorption was characterized by Fourier-transform infrared spectroscopy (FT-IR), scanning electron microscopy (SEM), and scanning transmission electron microscopy (STEM) analyses. The desorption study showed that the sorbent had up to 74% recovery and could be effectively used four times. These findings imply that this biosorbent can be applied as a promising, precise, and effective means of removing Pb2+ from contaminated waters. PRACTITIONER POINTS: In this study, the tolerance levels, bioaccumulation, and biosorption capacities of Pb in aqueous solutions were determined for the first time in recombinant MT2A and MT3 strains in which human MT2A and MT3 genes were cloned. The biosorbent of MT3, which was determined to be more effective in Pb bioaccumulation, was synthesized and used in Pb biosorption. The Pb biosorption mechanism of MT3 biosorbent was identified using isotherm modeling, kinetic modeling, and thermodynamic studies. The maximum Pb removal percentage capacity of the biosorbent was 90%, whereas the maximum biosorption capacity was up to 50 mg Pb2+ g-1 . These results indicated that MT3 biosorbent has a higher Pb biosorption capacity than existing recombinant biosorbents. MT3 biosorbent can be used as a promising and effective biosorbent for removing Pb from wastewater.

Treatment of anemia in myelofibrosis: focusing on novel therapeutic options.

INTRODUCTION: Myelofibrosis is a clonal myeloproliferative neoplasm associated with the proliferation of hematopoietic stem cells, increased bone marrow fibrosis, extramedullary hematopoiesis, hepatosplenomegaly, abnormal cytokine production, and constitutional symptoms. These and many other factors contribute to the development of anemia in myelofibrosis patients. AREAS COVERED: This review summarizes novel and promising treatments for anemia in myelofibrosis including transforming growth factor-ß inhibitors luspatercept and KER-050, JAK inhibitors momelotinib, pacritinib, and jaktinib, BET inhibitors pelabresib and ABBV-744, antifibrotic PRM-151, BCL2/BCL-XL inhibitor navitoclax, and telomerase inhibitor imetelstat. EXPERT OPINION: Standard approaches to treat myelofibrosis-related anemia have limited efficacy and are associated with toxicity. New drugs have shown positive results in myelofibrosis-associated anemia when used alone or in combination.

A disposable sensor based on one-pot synthesized tungsten oxide nanostructure-modified screen printed electrodes for selective detection of dopamine and uric acid.

Here, screen-printed carbon electrodes (SPCEs) were modified with ultrafine and mainly mono-disperse sea urchin-like tungsten oxide (SUWO3) nanostructures synthesized by a simple one-pot hydrothermal method for non-enzymatic detection of dopamine (DA) and uric acid (UA) in synthetic urine. Sea urchin-like nanostructures were clearly observed in scanning electron microscope images and WO3 composition was confirmed with XRD, Raman, FTIR and UV-Vis spectrophotometer. Modification of SPCEs with SUWO3 nanostructures via the drop-casting method clearly reduced the Rct value of the electrodes, lowered the ∆Ep and enhanced the DA oxidation current due to high electrocatalytic activity. As a result, SUWO3/SPCEs enabled highly sensitive non-enzymatic detection of DA (LOD: 51.4 nM and sensitivity: 127 µA mM-1 cm-2) and UA (LOD: 253 nM and sensitivity: 55.9 µA mM-1 cm-2) at low concentration. Lastly, SUWO3/SPCEs were tested with synthetic urine, in which acceptable recoveries for both molecules (94.02-105.8%) were obtained. Given the high selectivity, the sensor has the potential to be used for highly sensitive simultaneous detection of DA and UA in real biological samples.

Coronary artery bypass grafting in adolescent with myocardial infarction complicating undiagnosed Kawasaki disease.

Although Kawasaki disease is often self-limiting, significant cardiovascular sequelae may occur in the acute or late stage. The most common late complication is persistent coronary artery aneurysm, which can lead to myocardial ischaemia and even myocardial infarction. We report a case of coronary artery bypass grafting in a 16-year-old boy with a history of undiagnosed Kawasaki disease. Increased awareness of Kawasaki disease, especially among children between the ages of 6 months and 5 years, can increase early treatment and prevent serious complications that may occur in the future.

Successful treatment of acute myocardial injury of Duchenne muscular dystrophy with steroids: a case report.

BACKGROUND: Duchenne muscular dystrophy (DMD) is an X-linked muscular disease which is caused by the absence of dystrophin. Troponin elevation with acute chest pain may indicate acute myocardial injury in these patients. We report a case of DMD that presented with ACP and troponin elevation, who was diagnosed with acute myocardial injury, and successfully treated with corticosteroids. CASE PRESENTATION: A 9-year-old with DMD was admitted to the emergency department with the complaint of acute chest pain. His electrocardiogram (ECG) revealed inferior ST elevation and serum troponin T was elevated. The transthoracic echocardiography (TTE) demonstrated inferolateral and anterolateral hypokinesia with depressed left ventricular function. An ECG-gated coronary computed tomography angiography ruled out acute coronary syndrome. Cardiac magnetic resonance imaging revealed mid-wall to sub-epicardial late gadolinium enhancement at the basal to the mid inferior lateral wall of the left ventricle and corresponding hyperintensity on T2-weighted imaging, consistent with acute myocarditis. A diagnosis of acute myocardial injury associated with DMD was made. He was treated with anticongestive therapy and 2 mg/kg/day of oral methylprednisolone. Chest pain resolved the next day, and ST-segment elevation returned to normal on the third day. Troponin T decreased in the sixth hour of oral methylprednisolone treatment. TTE on the fifth day revealed improved left ventricular function. CONCLUSION: Despite advances in contemporary cardiopulmonary therapies, cardiomyopathy remains the leading cause of death in patients with DMD. Acute chest pain attacks with elevated troponin in patients with DMD without coronary artery disease may indicate acute myocardial injury. Recognition and appropriate treatment of acute myocardial injury episodes in DMD patients may delay the development of cardiomyopathy.

Turkish Thoracic Society Early Career Members Task Force Group's Virtual Congress Notes: European Respiratory Society International Congress 2020.

In this article, Early Career Task Force Group members of the Turkish Thoracic Society summarize the European Respiratory Society 2020 virtual congress. Current developments in the field of respiratory diseases were compiled with the addition of sessions specific to coronavirus disease 2019 this year. Almost all of the congress sessions were examined, and the important and striking results of the congress were highlighted. Congress sessions were attended by expert researchers, and the prominent messages of each session were highlighted in short summaries. They were then grouped under relevant titles and ranked in order of meaning and relation. It was finalized by a team of researchers.

Bioreduction and bioremoval of hexavalent chromium by genetically engineered strains (Escherichia coli MT2A and Escherichia coli MT3).

The number of studies on the removal of hazardous metals from water using genetic engineering technologies is growing. A high rate of metal ion removal from the environment is ensured, particularly through the expression of cysteine and thiol-rich proteins such as metallothioneins in bacterial cells. In this study, we used recombinant strains created by cloning the human metallothioneins MT2A and MT3 into Escherichia coli Jm109 to assess the removal and reduction of hexavalent chromium (Cr(VI)) from aqueous solutions. MT2A was the most effective strain in both Cr(VI) removal (89% in 25 mg/L Cr(VI)) and Cr(VI) reduction (76% in 25 mg/L Cr(VI)). The amount of Cr adsorbed per dry cell by the MT2A strain was 22 mg/g. The biosorption of total Cr was consistent with the Langmuir isotherm model. Scanning electron microscope (SEM) images revealed that the morphological structures of Cr(VI)-treated cells were significantly damaged when compared to control cells. Scanning transmission electron microscope (STEM) images showed black spots in the cytoplasm of cells treated with Cr(VI). Shifts in the Fourier transform infrared spectroscopy analysis (FTIR) spectra of the cells treated with Cr(VI) showed that the groups interacting with Cr were hydroxyl, amine, amide I, amide II, phosphoryl and carbonyl. When all of the experimental data was combined, it was determined that both MT2A and MT3 were effective in removing Cr(VI) from aqueous solutions, but MT2A was more effective, indicating that MT2A may be employed as a biotechnological tool.

Early Effects of Low Molecular Weight Heparin Therapy with Soft-Mist Inhaler for COVID-19-Induced Hypoxemia: A Phase IIb Trial.

In COVID-19-induced acute respiratory distress syndrome, the lungs are incapable of filling with sufficient air, leading to hypoxemia that results in high mortality among hospitalized patients. In clinical trials, low-molecular-weight heparin was administered via a specially designed soft-mist inhaler device in an investigator initiated, single-center, open-label, phase-IIb clinical trial. Patients with evidently worse clinical presentations were classed as the "Device Group"; 40 patients were given low-molecular-weight heparin via a soft mist inhaler at a dose of 4000 IU per administration, twice a day. The Control Group, also made up of 40 patients, received the standard therapy. The predetermined severity of hypoxemia and the peripheral oxygen saturation of patients were measured on the 1st and 10th days of treatment. The improvement was particularly striking in cases of severe hypoxemia. In the 10-day treatment, low-molecular-weight heparin was shown to significantly improve breathing capability when delivered via a soft-mist inhaler.

Pentraxin 3 levels and correlation with disease severity in patients with acute rheumatic fever.

OBJECTIVES: This study aims to investigate serum pentraxin 3 (PTX3) levels during acute episode of acute rheumatic fever (ARF) and their relationship with disease severity. PATIENTS AND METHODS: The prospective study was conducted between January 2015 and December 2018 and included 52 ARF patients (22 girls, 30 boys, mean age 10.7±2.1 years; range, 5 to 16 years) experiencing an acute episode and 22 healthy children (13 girls, 9 boys, mean age 10.3±3.8 years; range, 5 to 16 years). ARF patients were classified into three groups based on the clinical course: isolated arthritis (n=17), mild carditis (n=19), and moderate/severe carditis (n=16). Blood samples were collected from all patients before treatment and from the healthy children in the control group to measure PTX3 levels. PTX3 was measured using sandwich enzyme-linked immunosorbent assay method. RESULTS: Plasma PTX3 levels were significantly higher in ARF group compared to the control group (4.7±5.2 and 1.2±1.7 ng/mL, p<0.001). Subgroup analysis of serum PTX3 levels in ARF patients with isolated arthritis, mild carditis, and moderate/severe carditis (3.2±3.1 ng/mL, 4.3±5 ng/mL, and 6.7±6.6 ng/mL, respectively) showed that serum PTX3 was significantly higher in the moderate/severe carditis group compared to the other groups (p<0.05). Analysis of echocardiographic data showed that serum PTX3 was positively correlated with left ventricular end-diastolic diameter, left atrial diameters, and mitral A velocity and negatively correlated with E/A ratio (p<0.05; r=0.231, 0.402, 0.562, -0.586, respectively). CONCLUSION: High PTX3 level during an acute episode of ARF may help predict the clinical course and the severity of accompanying carditis. However, prospective studies with larger sample sizes are needed.

Violence against health employees in a child health and diseases clinic: A tertiary-level hospital example.

AIM: Violence in health is an important public health problem that threatens community peace. In our study, it was aimed to examine the state of exposure to violence among employees in our clinic in the last one year and our employees' opinions and attitudes about violence. MATERIAL AND METHODS: The study was performed cross-sectionally. In this study the Violent Incident Form developed by Arnetz (1998) was used as a data collection tool. RESULTS: A total of 182 healthcare workers were included in the study. Of the participants, 14 (7.7%) were faculty members, 37 (20.3%) were physicians, 24 (13.2%) were interns, 70 (38.5%) were nurses, 10 (5.5%) were medical secretaries, and 27 (14.8%) were ancillary health personnel. The female/male ratio was 143/39. Seventy-nine (43.4%) of the employees had been exposed to violence at least once in the last year. Of those experiencing violence, 57 (72%) were female, 28 (35%) were nurses, 21 (27%) were residents, 16 (20%) were interns, five (6.5%) were faculty members, five (6.5%) were allied health personnel, and four (5%) were medical secretaries. Physicians were exposed to violence with a higher rate (p<0.05). Exposure to violence was observed most frequently in the pediatric emergency department. Of all the violent incidents, 58% occurred during night shifts and 46% occurred during examination/treatment/physical care. The perpetrator was a patient in only one incident, the other perpetrators were patients' relatives, and 63% of the perpetrators were men. All violent incidents involved verbal violence, seven (8.8%) incidents contained elements of physical violence, such as spitting, pushing, kicking, biting, restraining or using an object. Only 29 (36.7%) of the 79 staff reported violence, and 50 (63.3%) did not take any action after the violence. CONCLUSION: Violence in health is a common and serious problem even in tertiary hospitals. In our study, only one-third of the affected staff reported violence after exposure to violence. The risk of violence should be reduced in order to ensure a safe work environment, which will be possible by raising awareness of healthcare workers and effective implementation of violence prevention programs.

Removal of oxytetracycline and determining its biosorption properties on aerobic granular sludge.

This study investigates biosorption of Oxytetracycline, a broad-spectrum antibiotic, using aerobic granular sludge as an adsorbent in aqueous solutions. A sequencing batch reactor fed by a synthetic wastewater was operated to create aerobic granular sludge. Primarily, the pore structure and surface area of granular sludge, the chemical structure and the molecular sizes of the pharmaceutical, operating conditions, such as pH, stirring rate, initial concentration of Oxytetracycline, during adsorption process was verified. Subsequently, thermodynamic and kinetic aspects of the adsorption were examined and adsorption isotherm studies were carried out. It was shown that the aerobic granular sludge was a good alternative for biosorption of this pharmaceutical. The pharmaceutical was adsorbed better at pH values of 6-8. The adsorption efficiency increased with rising ionic strength. Also, it was seen that the adsorption process was an exothermic process in terms of thermodynamics. The adsorption can be well explained by Langmuir isotherm model.

Environmental risk assessment of selected pharmaceuticals in Turkey.

In this study, environmental risks of selected pharmaceuticals were investigated to assess potential hazards. Ciprofloxacin, Clarithromycin, Cefuroxime axetil, antibiotics, Benzalkoniuman antiseptic, Paracetamol, an analgesic, and Naproxen, an anti-inflammatory, were selected due to their high rate of usage in Turkey. Ciprofloxacin was found to have the highest risk due to its high PEC/PNEC ratio (28.636). Benzalkonium, Paracetamol and Clarithromycin have a potential to cause environmental hazards. The biodegradation and biological concentration factors (BCF) of the drugs were also determined using EPA/STWIN and EPA/BCFWIN programs. The results illustrated that these pharmaceuticals are nonbiodegradable in wastewater treatment plants. The BCFs of Benzalkonium and Clarithromycin were found to be very high, 70.790 L/kg and 56.490 L/kg, respectively. It was suggested that alternative treatment methods other than biological ones should be investigated for these pharmaceuticals because of their low biodegradability. Also, unnecessary use of antibiotics is supposed to be discouraged to reduce environmental hazards.

Characterization and assessment of a large-scale domestic advanced wastewater treatment plant in Turkey.

The paper presents new studies about the removal efficiencies and characterization of the Municipal Wastewater Treatment Plant (MWWTP) in Kayseri, Turkey, which is serving for 800,000 population equivalents with the capacity of 110,000 m(3)/day, between 2006 and 2009. Kayseri discharges its effluents to Karasu Creek that downstream joins the Kizilirmak river, the longest river in Turkey discharging into the Black Sea. Four years of operation data between 2006 and 2009 calendar years were obtained from KASKI General Directorate. Influent and effluent samples were collected daily and suspended solids (SS), chemical oxygen demand (COD), biochemical oxygen demand in 5 days (BOD(5)), total nitrogen (TN), and total phosphorus (TP) were measured, aiming to study the evolution of the removal efficiencies for each year. The following yearly mean removal efficiencies were performed in the treatment plant: 94%, 97%, 97%, 95% for SS; 94%, 96%, 95%, 95% for COD; 98%, 98%, 98%, 98% for BOD(5); 84%, 87%, 89%, 82% for TN; and 71%, 86%, 80%, 86% for TP, in 2006, 2007, 2008, and 2009, respectively. The performance of Kayseri MWWTP was given both in terms of influent and effluent quality and in comparison with the current legislation on discharge limits to the receiving body. During the studied period, mean concentrations in the effluent did not exceed the imposed limits, but sometimes, higher values were noticed for SS, TN, and TP. In conclusion, the plant performances concerning these parameters were excellent and Kayseri MWWTP was operating efficiently according to the conventional control parameters.

Concurrent nitrite oxidation and aerobic denitrification in activated sludge exposed to volatile fatty acids.

The goal of this research was to investigate the simultaneous occurrence of nitrification and denitrification by activated sludge exposed to volatile fatty acids (VFAs) during aerobic wastewater treatment using a single-stage reactor. A mixture of VFAs was spiked directly into a continuous-stirred tank reactor (CSTR) to assess subsequent impacts on nitrite removal, nitrate formation, CO(2) fixation, total bacterial density, and dominant nitrite oxidizing bacteria (NOB) concentration (i.e., Nitrospira). The activity of the periplasmic nitrate reductase (NAP) enzyme and the presence of nap gene were also measured. A rapid decrease in the nitrate formation rate (>70% reduction) was measured for activated sludge exposed to VFAs; however, the nitrite removal rate was not reduced. The total bacterial density and Nitrospira concentration remained essentially constant; therefore, the reduction in nitrate formation rate was likely not due to heterotrophic uptake of nitrogen or to a decrease in the dominant NOB population. Additionally, VFA exposure did not impact microbial CO(2) fixation efficiency. The activity of NAP enzyme increased in the presence of VFAs suggesting that nitrate produced as a consequence of nitrite oxidation was likely further reduced to gaseous denitrification products via catalysis by NAP. Little, if any, nitrogen was discharged in the aqueous effluent of the CSTR after exposure to VFAs demonstrating that activated sludge treatment yielded compounds other than those typically produced solely by nitrification.

Volatile fatty acid impacts on nitrite oxidation and carbon dioxide fixation in activated sludge.

Batch test were performed to assess nitrite removal, nitrate formation, CO2 fixation, gaseous nitrogen production and microbial density in activated sludge exposed to volatile fatty acid (VFA) mixtures. Nitrite removal and nitrate formation were both affected by the presence of VFAs, but to different degrees. Nitrate formation rates were reduced to a greater extent (79%) than nitrite removal rates (36%) resulting in an apparent unbalanced nitrite oxidation reaction. Since the total bacterial density and the nitrite oxidizing bacteria (NOB, Nitrospira) concentration remained essentially constant under all test conditions, the reduction in rates was not due to heterotrophic uptake of nitrogen or to a decrease in the NOB population. In contrast to the nitrogen results, VFAs were not found to impact CO2 fixation efficiency. It appeared that nitrite oxidation occurred when VFAs were present since the oxidation of nitrite provides energy for CO2 fixation. However, nitrate produced from the oxidation of nitrite was reduced to gaseous nitrogen products. N2O gas was detected in the presence of VFAs which was a clear indication that VFAs stimulated an alternative pathway, such as aerobic denitrification, during biotransformation of nitrogen in activated sludge.