Integrated catalytic systems for simultaneous NOx and PM reduction: a comprehensive evaluation of synergistic performance and combustion waste energy utilization.

The global transition towards sustainable automotive vehicles has driven the demand for energy-efficient internal combustion engines with advanced aftertreatment systems capable of reducing nitrogen oxides (NOx) and particulate matter (PM) emissions. This comprehensive review explores the latest advancements in aftertreatment technologies, focusing on the synergistic integration of in-cylinder combustion strategies, such as low-temperature combustion (LTC), with post-combustion purification systems. Selective catalytic reduction (SCR), lean NOx traps (LNT), and diesel particulate filters (DPF) are critically examined, highlighting novel catalyst formulations and system configurations that enhance low-temperature performance and durability. The review also investigates the potential of energy conversion and recovery techniques, including thermoelectric generators and organic Rankine cycles, to harness waste heat from the exhaust and improve overall system efficiency. By analyzing the complex interactions between engine operating parameters, combustion kinetics, and emission formation, this study provides valuable insights into the optimization of integrated LTC-aftertreatment systems. Furthermore, the review emphasizes the importance of considering real-world driving conditions and transient operation in the development and evaluation of these technologies. The findings presented in this article lay the foundation for future research efforts aimed at overcoming the limitations of current aftertreatment systems and achieving superior emission reduction performance in advanced combustion engines, ultimately contributing to the development of sustainable and efficient automotive technologies.

Deconstructing the steps of pull-type PEG tube insertion.

Video 1Deconstructed steps of the pull-type PEG insertion technique.

Deconstructing the steps of PEG tube insertion using the introducer technique.

Video 1Deconstructed steps of the introducer-type PEG insertion technique.

Double balloon enteroscopy versus single balloon enteroscopy: A comparative study.

Device assisted enteroscopy (DAE) like the double balloon enteroscopy (DBE) and single balloon enteroscopy (SBE) are postulated to ease small bowel examination and performance of therapy. However, studies comparing the effectiveness of these 2 modalities have yielded varying results. The aim of this study is to compare the efficacy and safety of SBE and DBE. We retrospectively reviewed records of patients who underwent DBE (n = 82) or SBE (n = 45) for small bowel exam in our unit from January 2014 to January 2022. Our primary outcomes were to compare the technical success and diagnostic success rates between DBE and SBE. Our secondary outcomes were to compare the therapeutic success, and complication rates. The main indications were suspected GI bleeding (DBE 41.5% vs SBE 48.9%), iron deficiency anemia (DBE 9.8% vs SBE 4.4%) and small bowel lesions (DBE 28.0% vs SBE 44.4%) detected either from prior capsule endoscopy or radiological imaging. Majority of the enteroscopy exam was by antegrade approach (DBE 67.1% vs SBE 77.8%). We found no significant difference in the technical success (DBE 95.1% vs SBE 97.8%, P = .46), diagnostic success (DBE 69.5% vs SBE 77.8%, P = .36) and the therapeutic success rate (DBE 63.2% vs SBE 54.3%, P = .09) between the groups. Complications occurred in 1 case from each group (mucosal tear). None of the complications were major. In patients who underwent enteroscopy, the diagnostic and therapeutic performance of SBE is similar to DBE. Both procedures were safe with low complication rates.

Endoscopic sleeve gastroplasty using the novel single-channel suturing device: A multicenter experience.

Background and aim: Endoscopic sleeve gastroplasty (ESG) is an effective treatment for obesity. Recently, a novel single-channel endoscopic suturing device has been made available to overcome the need for a double-channel endoscope. However, there is limited evidence evaluating its utility for ESG. In this multicenter study, we aim to assess the efficacy and safety of the single-channel suturing device for ESG. Methods: We reviewed the records of 18 patients who underwent ESG using the novel device at the Singapore General Hospital, Singapore, and Siriraj Hospital, Bangkok, between 2020-2021. We adopted a "U" suture pattern. Our primary outcome was to assess technical feasibility and safety. The secondary outcome was to determine the percentage of total body weight loss at 1 year. Results: The mean ± SD age and body mass index were 42 ± 8.5 years and 34.9 ± 4.4 kg/m2, respectively. The majority were female (61%). ESG was technically successful in 94% (n = 17) of patients. Device dislodgement occurred in one patient. We used an average of five sutures (range, 4-8), and the mean ± SD procedure time was 96.5 ± 43.8 min. No complications occurred. The mean ± SD length of stay was 2.3 ± 1.5 days. The mean ± SD percentage of total body weight loss at 6 and 12 months were 16 ± 5.2% and 13.1 ± 5.8%, respectively. We found that >5%, >10%, and >15% total body weight loss was observed in 83.3%, 72.2%, and 56%, respectively. Conclusion: ESG using the single-channel endoscopic suturing system is safe and effective for inducing weight loss at 1 year in patients with obesity.

Impact of Chlorpyrifos on Cytopathological Indices in Mangrove Crab, Episesarma tetragonum (Fabricius).

Chlorpyrifos is an organophosphate insecticide occurring in aquatic ecosystems. Due to exposure to xenobiotics, several harmful effects on aquatic organisms are noticed worldwide. Mangrove crabs are an ecologically important aquatic invertebrate species in food web interactions and in the mangrove ecosystem. Therefore, this study aimed to evaluate the cytotoxic effects of chlorpyrifos on the mangrove crab, Episesarma tetragonum. Crabs were exposed to 0.0294 and 0.0588 ppm of chlorpyrifos for 7 and 28 days. Cytopathologic effects on the gill, hepatopancreas, and muscle were investigated, and observations were compared with a control group. The results suggest that chlorpyrifos induces time- and concentration-dependent cytopathological alternations in the gill and exhibited epithelial lifting, oedema, necrosis, and a fusion of secondary lamellae and haemorrhage. The deceased hepatopancreas showed infiltration, a large lumen formation, and the disappearance of haemocytes, while the muscle tissue showed atrophy, necrosis, a wavy appearance, an accumulation of granular material between muscle fibres, and fragmentation in a mangrove crab. This study shows the great potential of cytopathological investigations, allows us to assess the sensitivity of various aquatic animal species to potentially dangerous compounds, and calculates safe concentrations with which to reduce pesticide use.

Nutritional Management and Role of Multidisciplinary Follow-Up after Endoscopic Bariatric Treatment for Obesity.

The prevalence of obesity has risen exponentially, and patients living with obesity suffer from its debilitating consequences. The treatment options for obesity have expanded significantly and include lifestyle changes, pharmacotherapy, endoscopic bariatric therapies (EBTs), and bariatric surgery. Endoscopic bariatric therapies comprise volume-reducing procedures such as endoscopic gastroplasty and gastric space-occupying devices such as intragastric balloons. Because of its minimally invasive nature and ease of delivery, EBTs are increasingly being adopted as a treatment option for obesity in several centers. These procedures mainly achieve weight loss by inducing early satiety and reducing meal volume. While the technical aspects of EBTs have been well explained, the nutritional management surrounding EBTs and the effectiveness of multidisciplinary team for maximizing weight loss is less described. There is considerable variation in post-EBT care between studies and centers. In this paper, we review the existing literature and share our experience on nutrition and the role of multidisciplinary management of obesity following EBT.